Skip to main content
Fig. 3 | BMC Neurology

Fig. 3

From: Recurrent hemorrhage risk associated with medial target medullary artery anastomosis from the periventricular collateral vessel in adult patients with moyamoya disease

Fig. 3

Representative cases of target anastomotic territory patterns. Hemorrhagic sites during the acute phase are indicated by black arrowheads on noncontrast-enhanced CT scans. Target collateral vessels are indicated by white arrowheads and hemorrhagic sites are indicated by white arrows on angiograms. a: A 58-year-old man experienced an intraventricular hemorrhage and was treated with conservative therapy. A CT image (left) indicates the initial hemorrhagic site located at the left temporal horn of the lateral ventricle. Left anterior-posterior (middle) and lateral (right) carotid artery angiograms obtained at baseline demonstrate the anterior choroidal artery responsible for the hemorrhage. No obvious medullary artery anastomosis could be observed. After > 70 months of clinical follow-up, no recurrent hemorrhage had occurred. b: A 50-year-old man experienced a recurrent hemorrhage in the ipsilateral hemisphere. A CT image (left) indicates the initial hemorrhage in the posterior portion of the body of the left lateral ventricle. A CT image obtained 49 months later (second from left) demonstrates a recurrent hemorrhage in the initial hemorrhagic site. Anterior-posterior (second from right) and lateral (right) views of the left vertebral angiogram obtained at baseline reveal the lateral posterior choroidal artery responsible for the initial and recurrent hemorrhages. The angiograms demonstrate obvious medial medullary artery anastomosis between the target collateral vessel and the territory fed by the paracentral artery. (Modified with permission from Wang et al. AJNR Am J Neuroradiol. 2019;40(10):1665–1671.4). c: A 36-year-old woman experienced a recurrent hemorrhage in the ipsilateral hemisphere. A CT image (left) demonstrates the initial hemorrhage in the body of the left lateral ventricle. A CT image obtained 49 months later (second from left) demonstrates a recurrent hemorrhage near the initial hemorrhagic site. Anterior-posterior (second from right) and lateral (right) views of the left carotid angiogram obtained at baseline reveal the lenticulostriate artery anastomosis responsible for the initial and recurrent hemorrhages. The angiograms demonstrate obvious lateral medullary artery anastomosis between the target collateral vessel and the central artery territory. d: A 36-year-old man experienced an intraventricular hemorrhage and was treated with conservative therapy. CT images (confirmed by susceptibility-weighted imaging) (left and second from left) indicate the initial hemorrhagic site located at the left posterior body of the lateral ventricle. Left anterior-posterior (second from right) and lateral (right) carotid artery angiograms obtained at baseline demonstrate the anterior choroidal artery responsible for the hemorrhage. The angiograms demonstrate obvious multiple medullary artery anastomosis between the target collateral vessel and the anterior parietal artery, paracentral artery, and angular gyrus artery territory. After > 96 months of clinical follow-up, no recurrent hemorrhage had occurred

Back to article page
\