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Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associated with Acom aneurysms and provide an illustrative case.

Methods:

We combined our experience of one case of a unilaterally absent ICA associated with an Acom aneurysm with the 33 existing publications on the same subject in the literature, for a total of 40 cases. We provide a detailed systematic literature review of this association of vascular anomalies, exploring different aspects regarding the collateral pathways and how they impact management strategies and propose a management algorithm to deal with such association.

Results:

The mean age was 48.2 ± 16.5 years. The aneurysmal rupture was the most common presentation (75%). Agenesis was observed in 70% of patients, followed by hypoplasia (20%) and, finally, aplasia (10%). Lie Type A was the most common pattern of collaterals (50%), with Types B and D being of almost equal proportions. Most aneurysms were located at the A1-Acom junction contralateral to the anomalous side (Fisher’s Exact test;P= 0.03). One case of temporary clipping was reported in the literature.

Conclusion:

Acom aneurysms in patients with unilateral ICA anomalies, given they are more commonly present contralaterally, could be of acquired etiology, warranting periodic screening in asymptomatic patients. Temporary clipping might be safe in patients with Type D collateral pattern, while those with Types A or B may require intraoperative rupture risk assessment and a tailored management plan to avoid disrupting collateral flow and causing ischemia.

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Publication Date
Fri Mar 15 2019
Journal Name
Alustath Journal For Human And Social Sciences
A Developmental-Longitudinal Study of Request External Modifiers in Authentic and Elicited Data
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Publication Date
Sun Mar 05 2017
Journal Name
Baghdad Science Journal
Notes on Traces of a Symmetric Generalized (?, ?)-Biderivations and Commutativity in Prime Rings
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Let R be a 2-torision free prime ring and ?, ?? Aut(R). Furthermore, G: R×R?R is a symmetric generalized (?, ?)-Biderivation associated with a nonzero (?, ?)-Biderivation D. In this paper some certain identities are presented satisfying by the traces of G and D on an ideal of R which forces R to be commutative

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Publication Date
Mon Jun 30 2003
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Absorption of NO2 into Water and Nitric Acid Solutions in a Fixed Column
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Publication Date
Wed Sep 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
A Viscoplastic Modeling for Permanent Deformation Prediction of Rubberized and Conventional Mix Asphalt
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Publication Date
Sat Feb 14 2026
Journal Name
Journal Of The College Of Basic Education
A comparative study between students of smokers and non-smokers in endurance antenna
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Subjects took physical fitness for health imposed on the area of research that have become an important and clear answer to the many problems resulting from the nature of dealing with modern life current actions that were needed to be hours of manual work has become accomplished by modern technology circumstance minutes, and mediated equipment And machinery. The lack of traffic rights and further burdens the intellectual and psychological pressures and the typical method of work has led to the identification of kinetic activity, thereby threatening public health in many ways stands at the forefront of these threats the problem of smoking, which causes many types of cancers, notably lung cancer. The most important reasons that led to This dr

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Publication Date
Mon Sep 14 2015
Journal Name
Day 2 Tue, September 15, 2015
Modeling and History Matching of a Fractured Reservoir in an Iraqi Oil Field
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Abstract<p>In recent years the interest in fractured reservoirs has grown. The awareness has increased analysis of the role played by fractures in petroleum reservoir production and recovery. Since most Iraqi reservoirs are fractured carbonate rocks. Much effort was devoted to well modeling of fractured reservoirs and the impacts on production. However, turning that modeling into field development decisions goes through reservoir simulation. Therefore accurate modeling is required for more viable economic decision. Iraqi mature field being used as our case study. The key point for developing the mature field is approving the reservoir model that going to be used for future predictions. This can </p> ... Show More
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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Schema Theory and Text- worlds: A Cognitive Stylistic Analysis of Selected Literary Texts
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Cognitive stylistics also well-known as cognitive poetics is a cognitive approach to language. This study aims at examining literary language by showing how Schema Theory and Text World Theory can be useful in the interpretation of literary texts. Further, the study attempts to uncover how readers can connect between the text world and the real world. Putting it differently, the study aims at showing how the interaction between ‘discourse world’ and ‘text world’. How readers can bring their own experience as well as their background knowledge to interact with the text and make interpretive connections.        Schema and text world theories are useful tools in cognitive stylistic studies. The reader's perception o

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Publication Date
Thu Aug 11 2022
Journal Name
Arabian Journal For Science And Engineering
Synthesis and Characterization of Novel Nano Azo Compounds as a New pH Sensor
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Publication Date
Sat Jan 01 2022
Journal Name
Computer Networks, Big Data And Iot
A Comprehensive Study of Various DC Faults and Detection Methods in Photovoltaic System
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Publication Date
Wed Mar 01 2023
Journal Name
Iraqi Journal Of Physics
Bandwidth Improvement of a Cone-Inverted Cylindrical and Cross Hybrids Dielectric Resonator Antennas
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In this work, two cone-inverted cylindrical and cross-hybrid dielectric resonator antennas are stacked and excited by the coaxial probe method with an operating standard resonant frequency of 5.438 GHz. A drawback of these standard Dielectric Resonator Antennas (DRAs) is their narrow bandwidth. For good antenna performance, a stacked DR geometry and a thick dielectric substrate having a low dielectric constant are desired since this provides large bandwidth, better radiation power, reduces conductor loss and nonappearance of surface waves. Many approaches, such as changing the shape of the dielectric resonator, have been used to enhance bandwidth. Using DRA, having the lowest dielectric constant, increases the bandwidth and the electroma

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