Surgical anatomy of the proximal anterior cerebral artery

Abstract

The authors present this study of proximal anterior cerebral arteries in the normal human to provide a clearer basis for strategy in aneurysm surgery. They describe patterns of origin of branches, their subarachnoid course, and parenchymal distribution. Branches that originate from the anterior cerebral artery at the internal carotid bifurcation perfuse the genu and contiguous posterior limb of the internal capsule and the rostral thalamus. Proximal 4-mm branches supply the anterior limb of the internal capsule, the neighboring hypothalamus, anteroventral putamen, and pallidum. The remaining anterior cerebral artery proximal to the communicating artery sends branches to the optic chiasm, the adjacent hypothalamus, and the anterior commissure. Heubner's artery arises directly opposite the anterior communicating artery to supply much of the striatum and internal capsule rostral to the anterior commissure. The anterior communicating artery branches supply the fornix, corpus callosum, septal region, and anterior cingulum. The parenchymal distribution of these end arteries may be surmised from the site of origin named vessels. With this anatomical information one can avoid interruption of blood supply to vital structures when dealing with the anterior cerebral artery and its branches.

Measurement of optic nerve blood flow during dissection of parasellar tumors

“…We also found that temporary occlusion of small arteries adjacent to the optic nerve reduced ONBF, a result compatible with anatomic findings [6,10,21,29,32]. Intraoperative injury to these small arteries can produce optic nerve ischemia that leads to postoperative visual deterioration [2,12].…”

“…The superior group consists of tiny branches that arise from the lower wall of the A1 segment of the anterior cerebral artery and anterior communicating artery. They pass above the optic pathway to supply to the upper surface of the optic nerve, optic tract, and the lateral portion of the chiasm [6,10,21,29,32]. The inferior group, derived from the basilar, posterior communicating, posterior cerebral, and internal carotid arteries, supplies the inferior surface of the optic nerve, optic tract, and most of the optic chiasm [13,32].…”

Branches of the Anterior Cerebral Artery Near the Anterior Communicating Artery Complex: an Anatomic Study and Surgical Perspective

“…The overall preponderance of data suggests that the RAH most typically arises as a single artery, but our data support the notion of variability in the number of RAHs in any one hemisphere. The take-off of the RAH may be at the same level in both cerebral hemispheres, 12) directly opposite the ACoA or in very close proximity in 90% of cases, 2) or the artery may arise either opposite to or within 5 mm of the ACoA in 95% of cases. 5) Our study shows that the RAH appears to arise most often in close proximity to the ACoA junction.…”

“…[1][2][3][4][5][6][7][8][9][10] The vascular relationships of this region are especially important as pathology requiring surgical treatment is often found here. Successful surgery without incurring significant neurovascular morbidity in this region depends on knowledge of its detailed vascular anatomy.…”

Brain Commissural Anomalies

“…The medial portion of the anterior commissure and the column of the fornix, are supplied by the small perforating branches of the hypothalamic arteries (Türe et al, 1996;Dunker & Harris , 1976) and the remaining anterior cerebral artery proximal to the anterior communicating artery (Dunker & Harris , 1976). The hypothalamic arteries arise from the posteroinferior aspect of the anterior communicating artery (Türe et al, 1996).…”