title: Three-Dimensional Angiographic Evaluation of Middle Cerebral Artery Trunk Aneurysms: Demonstration of the Close Relationship Between the Early Frontal Cortical Branches and Lateral Lenticulostriate Arteries.
abstract: BACKGROUND
  For the treatment planning of a patient with a middle cerebral artery (MCA) trunk aneurysm, understanding the anatomic relationship among the aneurysm, branching vessels, and lenticulostriate arteries (LSAs) is important. We aimed to demonstrate the branching-vessel anatomy related to an MCA trunk aneurysm using 3-dimensional (3D) angiography.
  
  
  METHODS
  We retrospectively reviewed 3D angiographic findings of 64 cases of MCA trunk aneurysms using a 3D workstation with various postprocessing conditions. We classified the aneurysms into 4 groups (early frontal cortical branch [EFCB], early temporal cortical branch [ETCB], LSA, and nonbranching aneurysms) and analyzed the relationship between the branching vessels and the LSAs.
  
  
  RESULTS
  There were 30 EFCB aneurysms, 25 ETCB aneurysms, 7 LSA aneurysms, and 2 nonbranching aneurysms. Twenty-six (86.7%) of the 30 EFCB aneurysms shared common origins and were associated with the LSAs, but none of the 25 ETCB aneurysms were. Three of 24 patients who received clipping for an EFCB aneurysm experienced a postoperative infarction in the LSA territory. In these 3 patients, the LSA originated from the EFCB and was closely related with the aneurysm.
  
  
  CONCLUSIONS
  We have identified a clinically important anatomic relationship between the MCA trunk aneurysm and branching vessels, including the LSAs. EFCB aneurysms show a close relationship with the LSAs. Pretreatment identification of the origin of the LSAs is important to obviate any perforator injury in EFCB aneurysms.
authors.affiliation: Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jung Cheol
authors.initials: JC
authors.lastname: Park
authors.affiliation: Department of Radiology, Ulsan Hospital, Ulsan, Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Shim
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address: dhlee@amc.seoul.kr.
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Ahn
authors.affiliation: Department of Neurology, Sejong General Hospital, Bucheon, Korea.
authors.forename: Dong-Geun
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Kuhyun
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Wonhyoung
authors.initials: W
authors.lastname: Park
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hae-Won
authors.initials: HW
authors.lastname: Koo
authors.affiliation: Department of Medical Biotechnology, Dongguk University, Ilsan, Korea.
authors.forename: Yuan Yuan
authors.initials: YY
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Do Hoon
authors.initials: do H
authors.lastname: Kwon
authors.affiliation: Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Byung Duk
authors.initials: BD
authors.lastname: Kwun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Cerebral angiography; Intracranial aneurysm; Lateral lenticulostriate artery; Middle cerebral artery; Three-dimensional image