Elsevier

Clinical Imaging

Volume 25, Issue 4, July–August 2001, Pages 258-261
Clinical Imaging

Persistent primitive olfactory artery: Diagnosis with MR angiography

https://doi.org/10.1016/S0899-7071(01)00294-7Get rights and content

Abstract

We present a case of persistent primitive olfactory artery (PPOA) diagnosed with the aid of magnetic resonance (MR) angiography. The proximal right anterior cerebral artery (ACA) had an extremely long anteroinferomedial course along the ipsilateral olfactory tract, made a hairpin turn posterosuperiorly, and became a normal distal ACA. After reviewing the literature, we considered the proximal segment of this anomalous ACA to be a PPOA. To our knowledge, this is the first report of a patient with this anomalous ACA diagnosed with MR angiography.

Introduction

Persistent primitive olfactory artery (PPOA) is a rare anomaly of the anterior cerebral artery (ACA). Yamaura et al. [1] reported the first case of this anomaly in 1979. We found 13 PPOAs reported in 11 cases in the literature [1], [2], [3], [4], [5], [6]. In 5 of the 13 PPOAs, a saccular aneurysm was found on the anomalous artery. We present a case of PPOA diagnosed with the aid of magnetic resonance (MR) angiography.

Section snippets

Case report

A 18-year-old man with a clinical diagnosis of epilepsy underwent cranial MR imaging and MR angiography. Two years before the present MR examinations, he began having seizures involving tonic convulsions of bilateral upper extremities and paresis of the right arm. MR imaging showed no abnormality. MR angiography with a three-dimensional (3D) time-of-flight (TOF) technique revealed an anomalous right ACA (Fig. 1a–c). The proximal portion of the right ACA coursed anteroinferomedially along the

Discussion

There are several rare types of ACA anomalies including fenestration [7] and anomalous internal carotid artery-ACA anastomosis [8]. PPOA is also rarely reported in the literature and all reports are from Japan [1], [2], [3], [4], [5], [6]. Including our patient, 12 cases of PPOA have been reported, involving four men and eight women whose ages ranged from 18 to 73 years (mean 55 years). The PPOA was found on the right side in five patients, left in five, and bilaterally in two.

According to

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