Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Jun 26;6(2):133-138.
doi: 10.4103/bc.bc_10_20. eCollection 2020 Apr-Jun.

Internal carotid artery origin of the anterior cerebral artery: A rare anatomic intracranial arterial variation in a child with morning glory disc anomaly and moyamoya vascular pattern; case report and review of literature

Aikaterini Solomou  1 , Kanellos C Spiliopoulos  1 , Georgios Vasilagkos  1 , Athanasios Vagionis  1 , Petros Zampakis  1
Affiliations
Case Reports

Internal carotid artery origin of the anterior cerebral artery: A rare anatomic intracranial arterial variation in a child with morning glory disc anomaly and moyamoya vascular pattern; case report and review of literature

Aikaterini Solomou et al. Brain Circ. .

Abstract

Morning glory disc anomaly (MGDA) characterizes a congenital dysgenetic disorder of the optic disc, coexisting with arterial intracranial abnormalities, including Moyamoya vascular disease, a significantly rare disease in the European populations. We report a 2.5-year-old female child from Greece previously diagnosed with MGDA, who presented with right-hand paresis, accompanied by focal epileptic spasms, followed by an episode of brief absence seizure, as well as some arm clonic spasms. Magnetic resonance angiography scan revealed the presence of an anomalous origin of the anterior cerebral artery (ACA) from the internal carotid artery (ICA) along with vascular abnormalities, compatible with Moyamoya pattern. To the very best of our knowledge, this is the first reported case of anomalous origin of ACA from the supraclinoid ICA accompanied by severe occlusive intracranial disease (moyamoya-like pattern) in a patient with known MGDA, highlighting the embryonic character of the vascular manifestations in MGDA. It also verifies the association of Moyamoya pattern with MGDA, thus linking vascular dysgenesis as a possible cause of MGDA.

Keywords: Cerebral arterial diseases; intracranial arterial diseases; morning glory disc anomaly; moyamoya disease; moyamoya vascular pattern.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Time of flight magnetic resonance angiography shows segmental occlusion of the M1 segment of the right middle cerebral artery, severe stenosis of the terminal left internal carotid artery and the middle cerebral artery, as well as occlusion of the terminal right internal carotid artery, before the carotid tip middle cerebral artery
Figure 2
Figure 2
Axial image (time of flight magnetic resonance angiography) depicts severe narrowing of the left internal carotid artery, at the level of the origin of ipsilateral ophthalmic artery
Figure 3
Figure 3
Lateral projection of the intracranial arteries (time-of-flight magnetic resonance angiography) shows the presence of anomalous origin of anterior cerebral artery from the internal carotid artery. The vessel runs cranially in a ventral course and then characteristically turns dorsally to join the anterior communicating artery area
Figure 4
Figure 4
Axial fluid-attenuated inversion recovery image at the level of optic chiasm shows high signal within the subarachnoid space of the left occipital lobe
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lee BJ, Traboulsi EI. Update on the morning glory disc anomaly. Ophthalmic Genet. 2008;29:47–52. - PubMed
    1. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Engl J Med. 2009;360:1226–37. - PubMed
    1. Hever P, Alamri A, Tolias C. Moyamoya angiopathy – Is there a Western phenotype? Br J Neurosurg. 2015;29:765–71. - PubMed
    1. Kindler P. Morning glory syndrome: Unusual congenital optic disk anomaly. Am J Ophthalmol. 1970;69:376–84. - PubMed
    1. Azuma N, Yamaguchi Y, Handa H, Tadokoro K, Asaka A, Kawase E, et al. Mutations of the PAX6 gene detected in patients with a variety of optic-nerve malformations. Am J Hum Genet. 2003;72:1565–70. - PMC - PubMed

Publication types