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Research ArticlePediatric Neuroimaging

Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population

S. Lee, S.-K. Kim and J.H. Phi
American Journal of Neuroradiology June 2021, 42 (6) 1157-1162; DOI: https://doi.org/10.3174/ajnr.A7059
S. Lee
aFrom the Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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S.-K. Kim
aFrom the Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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J.H. Phi
aFrom the Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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  • FIG 1.
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    FIG 1.

    STA classification. Class A corresponds to classic STA anatomy with a single frontal and parietal branch. Classes B1, B2, and B3 illustrate additional frontal, parietal, or both branches, respectively. Class C1, C2, and C3 illustrate hypoplasia of the parietal, frontal, or both branches, respectively. Class D1 and D2 illustrate aplasia of the parietal and frontal branches, respectively.

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    FIG 2.

    PAA classification. The thin solid line indicates the vertex; the dashed vertical line indicates the external auditory canal midline; and the thick solid line indicates the helix. Class 1 illustrates PAA terminating below the helix, class 2 illustrates the PAA terminating at the helix, class 3 illustrates the PAA terminating between the helix and the vertex, and class 4 illustrates the PAA terminating at the vertex. For classes 3 and 4, if the PAA advances anteriorly passing the vertical line, the class is annotated with “a” for anteriority and, if not, “p” for posteriority.

  • FIG 3.
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    FIG 3.

    PAA-EDAS candidates.

  • FIG 4.
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    FIG 4.

    Representative illustrations of late arterial phase external carotid artery angiography with postoperative collateral formation after PAA-EDAS. A, Right PAA-EDAS case of 1.7-year-old boy representing Matsushima grade A. B, Right PAA-EDAS case of 8-year-old boy representing Matsushima grade B.

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    Table 1:

    Demographics of 572 patients

    DemographicsValue
    Sex (n = 572)
        Male255 (44.6%)
        Female317 (55.4%)
    Age of diagnosis (yr)
        Younger than 355 (9.7%)
        3∼7230 (40.2%)
        8∼11188 (32.8%)
        12∼1473 (12.7%)
        15∼1826 (4.5%)
    Unilateral (n = 112)
        Right58 (51.8%)
        Left54 (48.2%)
    Average follow-up period (yr)6.1
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    Table 2:

    Distribution of STA and PAA

    DistributionNo. (%)
    STA
        A380 (33.2%)
        B1254 (22.2%)
        B2139 (12.2%)
        B3250 (21.8%)
        C133 (2.8%)
        C226 (2.3%)
        C326 (2.3%)
        D119 (1.7%)
        D217 (1.5%)
        Total1144 (100%)
    PAA
        1563 (49.2%)
        2127 (11.1%)
        3a162 (14.2%)
        3p267 (23.3%)
        4a18 (1.6%)
        4p8 (0.6%)
        Total1144 (100%)
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American Journal of Neuroradiology: 42 (6)
American Journal of Neuroradiology
Vol. 42, Issue 6
1 Jun 2021
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Cite this article
S. Lee, S.-K. Kim, J.H. Phi
Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population
American Journal of Neuroradiology Jun 2021, 42 (6) 1157-1162; DOI: 10.3174/ajnr.A7059

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Anatomic Variation of the Superficial Temporal Artery and Posterior Auricular Artery in a Pediatric Moyamoya Disease Population
S. Lee, S.-K. Kim, J.H. Phi
American Journal of Neuroradiology Jun 2021, 42 (6) 1157-1162; DOI: 10.3174/ajnr.A7059
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