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      Albert Wojciech Adamkiewicz (1850–1921): unsung hero behind the eponymic artery

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          Abstract

          The artery of Adamkiewicz is an important radiculomedullary artery supplying the spinal cord, especially the lumbar enlargement. Anatomical knowledge of this artery is important for avoiding serious neurological complications during surgery performed in this region—for neurosurgeons and interventional radiologists treating intramedullary tumors and spinal arteriovenous malformations, traumatologists performing spinal fusions, thoracic surgeons treating aortic aneurysms, and urologists and pediatric surgeons conducting retroperitoneal dissections. However, the biography of the talented Polish pathologist Albert Adamkiewicz, after whom the landmark artery is named, has not been described adequately in the existing neurosurgical literature. The authors bring to light the historical perspective of the eponymic artery and provide a recapitulation of other significant contributions made by Adamkiewicz, mostly involving the nervous system. His research papers on the histology of neuronal tissues and neurodegenerative diseases had high scientific merit, but the discovery of the anticancer antitoxin “cancroin” and his postulation of a cancer-causing parasite he named “Coccidium sarcolytus” met with harsh criticism and eventually led to his ill fame. The biography is supplemented with a brief overview of the important surgical implications of the artery of Adamkiewicz.

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          Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery.

          The blood supply of the lower spinal cord is heavily dependent on the artery of Adamkiewicz, which characteristically originates from one of the thoracolumbar segmental arteries. The aforementioned artery is of enormous clinical, surgical, and radiological importance, and the goal of this study was to elucidate the course and branches of the segmental artery that gives rise to this important vessel. In this cadaveric, microsurgical anatomical study, the authors investigate and describe the course and branches of the artery of Adamkiewicz and the segmental branch from which it ultimately originates. A review of the literature is provided. By documenting the microsurgical anatomy of these important vessels, this study facilitates an understanding of the anatomy that will aid in treatment planning for surgery of various lesions in this area.
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            Demonstration of the artery of Adamkiewicz at multi- detector row helical CT.

            To assess the ability of multi-detector row helical computed tomography (CT) to depict the artery of Adamkiewicz. Seventy patients with vascular diseases underwent multi-detector row helical CT of the entire aorta and iliac arteries. The artery of Adamkiewicz was examined on multiplanar and curved planar reformation images and on cine-mode displays. The visualization of the artery of Adamkiewicz, as well as its branching level and side of origin, was investigated. In 63 (90%) of the 70 patients, at least a single artery of Adamkiewicz was clearly visualized from the intervertebral foramen to the hairpin-shaped union with the anterior spinal artery. Two arteries of Adamkiewicz were identified in 15 (24%) of 63 patients. Fifty-five arteries of Adamkiewicz (71%) originated from the left side. Seventy-two (92%) originated between T8 and L1. Neither the intercostal vein nor the posterior spinal vein were visualized in 57 of 63 patients. Continuity of the entire length, starting from the stem of the intercostal or lumbar artery and proceeding to the artery of Adamkiewicz and finally to the anterior spinal artery, was traceable on cine-mode displays or on curved planar reformation images in 20 of 63 patients. Multi-detector row helical CT depicts the artery of Adamkiewicz in a high percentage of patients.
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              MR angiography and CT angiography of the artery of Adamkiewicz: state of the art.

              It is very important to assess the artery of Adamkiewicz before repair of the thoracoabdominal or descending thoracic aorta. Several studies have demonstrated the feasibility and advantages of noninvasive assessment of the artery of Adamkiewicz with magnetic resonance (MR) angiography and multi-detector row computed tomographic (CT) angiography. Recent advances in MR angiography and CT angiography have led to changes in the detectability of this artery. In the present study, both MR angiography and CT angiography were performed without complications for preoperative evaluation of 30 patients who underwent repair of the thoracoabdominal or descending thoracic aorta. MR angiography provided detection rates as high as 93% and 80% with the morphologic "hairpin turn" criterion and the anatomic "continuity" criterion, respectively. Sixteen-detector row CT angiography provided detection rates as high as 83% and 60%, respectively. Use of both MR angiography and CT angiography provided higher detection rates of 97% and 90%, respectively. The collateral pathways were depicted in seven cases (23%). MR angiography is superior for depiction of the artery of Adamkiewicz, especially when it arises from the false lumen of a dissecting aneurysm. CT angiography has a wide field of view and allows depiction of significant collateral pathways associated with the internal thoracic artery and intercostal arteries.
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                Author and article information

                Journal
                Neurosurgical Focus
                FOC
                Journal of Neurosurgery Publishing Group (JNSPG)
                1092-0684
                January 2009
                January 2009
                : 26
                : 1
                : E2
                Article
                10.3171/FOC.2009.26.1.E2
                d42681df-05d1-4565-a518-d14fbcd762fc
                © 2009
                History

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