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Interv Neuroradiol ; : 15910199211039924, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34516323


BACKGROUND: Congenital aortic arch anomalies are commonly encountered during neurointerventional procedures. While some anomalies are identified at an early age, many are incidentally discovered later in adulthood during endovascular evaluations or interventions. Proper understanding of the normal arch anatomy and its variants is pivotal to safely navigate normal aortic arch branches and to negotiate the catheter through anomalies during neurointerventional procedures. This is particularly relevant in the increasingly "transradial first" culture of neurointerventional surgery. Moreover, some of these anomalies have a peculiar predilection for complications including aneurysm formation, dissection, and rupture during the procedure. Therefore, an understanding of these anomalies, their underlying embryological basis and associations, and pattern of circulation will help endovascular neurosurgeons and interventional radiologists navigate with confidence and consider relevant pathologic associations that may inform risk of cerebrovascular disease. METHODS: Here, we present a brief review of the basic embryology of the common anomalies of the aortic arch along with their neurological significances and discuss, through illustrative cases, the association of aortic arch anomalies with cerebral vascular pathology. CONCLUSIONS: Understanding the aortic arch anomalies and its embryological basis is essential to safely navigate the cerebral vascular system during neurointerventional surgeries.

World Neurosurg ; 155: 135-143, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34363996


For thousands of years, anatomical models have served as essential tools in medical instruction. While human dissections have been the regular source of information for medical students for the last few centuries, the scarcity of bodies and the religious and social taboos of previous times made the process of acquiring human cadavers a challenge. The dissection process was dependent on the availability of fresh cadavers and thus was met with a major time constraint; with poor preservation techniques, decomposition turned the process of employing bodies for instruction into a race against time. However, the advent of anatomical models has countered this issue by supplying accurate anatomical detail in a physical, three-dimensional form superior to that of the two-dimensional illustrations previously used as the primary adjunct to dissection. Artists worked with physicians and anatomists to prepare these models, creating an interdisciplinary interaction that advanced anatomical instruction at a tremendous rate. These models have taken the form of metal, wood, ivory, wax, papier-mâché, plaster, and plastic and have ultimately evolved into computerized and digital representations currently. We provide a brief historical overview of the evolution of anatomical models from a unique neuroanatomical perspective.