Microsurgical Anatomy and Clinical Significance of the Anterior Communicating Artery and Its Perforating Branches
- 1 June 1997
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 40 (6), 1211-1218
- https://doi.org/10.1097/00006123-199706000-00019
Abstract
Precise identification of the anomalous anterior communicating artery (ACoA) or the perforating branches of the ACoA is usually difficult on preoperative angiograms because of the vascular complexity around the ACoA and its small-caliber branches. The purpose of this study was to review the microsurgical anatomy of the ACoA and its branches to show their importance for the interhemispheric trans-lamina terminalis approach and ACoA aneurysmal surgery.In 30 cadaver brains, the ACoA and its branches were examined under magnification using a surgical microscope.The ACoA was evident in all specimens and had variations consisting of plexiform (33%), dimple (33%), fenestration (21%), duplication (18%), string (18%), fusion (12%), median artery of the corpus callosum (6%), and azygous anterior cerebral artery (3%). The perforating branches were also observed in all cadaver brains. They were classified into subcallosal, hypothalamic, and chiasmatic branches according to their vascular territories. The subcallosal branch, usually single and the largest, supplied the bilateral subcallosal areas, branching off to the hypothalamic area. The hypothalamic branches, multiple and of small caliber, terminated in the hypothalamic area.The incidence of anomalous ACoA was higher than has been previously reported, and any segment of the anomalous ACoA may have perforating branches regardless of diameter. Among the three branches, the subcallosal branch is the most important because it feeds bilateral subcallosal areas branching to the hypothalamic area.Keywords
This publication has 15 references indexed in Scilit:
- Lamina terminalis approach for retrochiasmal craniopharyngiomasChild's Nervous System, 1990
- Branches of the anterior communicating arteryActa Neurochirurgica, 1990
- Removal of tumors in the III ventricle using the lamina terminalis approachChild's Nervous System, 1989
- Memory impairment following ruptured aneurysm of the anterior communicating arteryBrain and Cognition, 1988
- Anterior communicating artery aneurysms with associated anomaliesJournal of Neurosurgery, 1980
- The anterior communicating artery has significant branches.Stroke, 1977
- Surgical anatomy of the proximal anterior cerebral arteryJournal of Neurosurgery, 1976
- Aneurysms of the Anterior Communicating Artery and Gross Anomalies of the Circle of WillisJournal of Neurosurgery, 1966
- KORSAKOFF'S SYNDROME AFTER OPERATION ON RUPTURED ANEURYSM OF THE ANTERIOR COMMUNICATING ARTERYActa Psychiatrica Scandinavica, 1966
- THE BLOOD VESSELS OF THE HUMAN OPTIC CHIASMA AND THEIR RELATION TO THOSE OF THE HYPOPHYSIS AND HYPOTHALAMUSBrain, 1958