Cerebrovascular EmbryologyOctober 6, 2000
Brain School
Resident: Dr. Charles Matouk
Supervisor: Dr. Chris Wallace
Primitive Aortic Arches
Key Points
1) Cephalic location of primitive heart
2) 6 pairs of primitive aortic arches
3) Thoracic migration of heart and step-wise arch regression
Primitive Aortic Arches
Major Events
1) Regression of dorsal aorta between 3rd and 4th arches
2) Derivation of subclavian arteries from 6th intersegmental arteries
3) Attenuation of R 4th aortic arch
4-mm Fetal Stage
1st arch – involution and mandibular artery remnant
2nd arch – involution and hyoid artery remnant
3rd arch – precursor of ICA and ECA
4-mm Fetal Stage
Cranial division of primitive ICA – primitive ACA
Caudal division – precursor of PComA
ACA is the direct embryonic continuation of ICA, not MCA!!!
4-mm Fetal Stage
In hindbrain, arterial vasculature defined by paired, separate longitundinal nerual plexi
Supplied by anastomotic branches of primitive ICA and C1 segmental artery, and others
Embryonic Carotid-Basilar Anastomoses
1) Persistent trigeminal artery
2) Otic artery
3) Hypoglossal artery
4) Proatlantal intersegmental artery
5-6-mm Fetal Stage
Ventral pharnygeal artery (precursor of proximal ECA vasculature) now prominent
Caudal division of ICA forms anastomoses with cranial-end of bilateral longitudinal neural arteries
7-12-mm Fetal Stage
Ventral pharyngeal system more extensive with identifiable branches (precursor of proximal ECA)
Hyoid artery (precursor of upper portion of ECA)
7-12-mm Fetal Stage
Vertebral arteries formed by coalescence of longitudinal anastomoses between cervical segmental arteries
Drapkin AJ. The double lumen sign: a pathognomonic sign of arterial dissection?
Diagnostic Neuroradiology 42:203-205;2000.
12-14-mm Fetal Stage
Plexiform anastomosis between ACAs evolve into AComA
16-18-mm Fetal Stage
Stapedial artery (branch of hyoid artery) at zenith of development)
Its development defines distal ECA circulation and middle meningeal artery.
16-18-mm Fetal Stage
Fate of stapedial artery … proximal trunk regression with annexation of territories by ventral pharnygeal trunk and ophthalmic arteries
Evolution of Primitive Ophthalmic Arteries
1) Ventral (from ACA) ophthalmic artery
2) Dorsal ophthalmic artery
When dorsal persists or is dominant, ophthalmic artery originates from cavernous segment of ICA
Evolution of Posterior Circulation
PCA arising from ICA, predominantly or exclusively, is described as being of ‘fetal origin’
Review
Review
Review
Review
References
1. Morris, P. Practical Angiography. 1997. Williams & Wilkins, Baltimore, Maryland. Chapter 5, pp 89-98.
2. Osborn, A. Diagnostic Neuroradiology. 1994. Mosby, St. Louis, Missouri. Chapter 6, pp 117-153.
3. Moore KL and Persaud TVN. 1998. W.B. Saunders Company, Philadelphia, Pennsylvania. Chapter 349-403.