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Abstract

Review Article | Open Access

Volume 2026 - 3 | Article ID 235 | http://dx.doi.org/10.62057/ESJ.2024.V3.I5

CEREBRAL ARTERIAL VARIANTS AND THE NEUROGENESIS-ANGIOGENESIS AXIS: IMPLICATIONS FOR INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING, A NARRATIVE REVIEW AND CONCEPTUAL SYNTHESIS

Received
2026-06-18 		Revised
2026-06-27 		Accepted
2026-07-01 		Published
2026-07-06

Seyedeh Haniyeh Mortazavi1*

1.Surgical Neurophysiologist, Neuromodulation and Pain Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Corresponding Author:  Seyedeh Haniyeh Mortazavi, Surgical Neurophysiologist, Neuromodulation and Pain Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Email:haniyehmortazavi.kums.ac@gmail.com

Citation: Seyedeh Haniyeh Mortazavi (2026). Cerebral Arterial Variants and the Neurogenesis-Angiogenesis Axis: Implications for Intraoperative Neurophysiological Monitoring, A Narrative Review and Conceptual Synthesis.Eco Science Journal.2026 3(5).

 

Copyrights ©  2026, Seyedeh Haniyeh Mortazavi. This article is licensed under the Creative Common Attribution-NonCommercial-4.0-international-License-(CCBY-NC).


Abstract: The cerebral arterial tree displays substantial inter-individual anatomical variability, arising from incomplete, asymmetric, or persistent regression of embryonic vascular plexuses. Beyond their established relevance to interventional and surgical planning, these variants intersect with a second, less frequently connected body of evidence: the molecular and cellular coupling between angiogenesis and neurogenesis within the adult and injured brain. Intraoperative neurophysiological monitoring (IONM), now standard practice in cerebrovascular and skull-base surgery, provides a continuous functional readout of neural pathways whose integrity depends on both the conducting arteries and their downstream microvascular and neurogenic niches. This narrative review synthesizes current literature across three domains: (1) the embryology and clinical significance of cerebral arterial variants, (2) the coupling of neurogenesis and angiogenesis in the neurovascular niche, and (3) the application and diagnostic performance of IONM in cerebrovascular surgery. Building on this synthesis, we outline a conceptual, hypothesis-generating framework in which preoperative knowledge of a patient's vascular variant anatomy and collateral capacity could inform the interpretation of intraoperative signal changes and guide future correlative research. This article is offered as a perspective intended to motivate mechanistic and clinical investigation; it does not report new anatomical findings, original patient data, or a completed study. 

Keywords: Cerebral Arterial Variants, Neurovascular Niche, Angiogenesis, Neurogenesis, Intraoperative Neurophysiological Monitoring, Collateral Circulation, Circle of Willis.

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