A neurosurgical view of anatomical variations of the distal anterior cerebral artery: an anatomical study

Ugur, Hasan Çağlar; Kahiloğulları, Gökmen; Esmer, Ali Fırat; Cömert, Ayhan; Odabaşı, Aysun Balseven; Tekdemi̇r, İbrahi̇m; Elhan, Alai̇tti̇n; Kanpolat, Yücel

doi:10.3171/jns.2006.104.2.278

Cited by 46 publications

(41 citation statements)

References 30 publications

(3 reference statements)

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“…We evaluated 18 patients treated for ruptured DACA aneurysm. Successful clipping was achieved in all of these patients, with no recurrence of SAH at 6 months and no need for retreatment (2,28,25).…”

Section: Clinical Outcomementioning

confidence: 97%

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Gherasim¹,

Gyorki²,

Bălaşa³

2017

Romanian Neurosurgery

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Objective: This study presents the experience of one neurosurgical center in the treatment of 18 consecutive patients with distal anterior cerebral artery (DACA) aneurysms during a 10 years period. Our aim was to compare treatment outcomes of these lesions with intracranial aneurysms in general, and to present technical nuances in surgical treatment. Methods: We analyzed the clinical and radiological data of 18 patients treated between 2005 and 2015. All patients were treated surgically using the microscope. No patients were lost to follow-up. We compared treatment and outcome of ruptured DACA aneurysms (n 18) with all consecutive ruptured aneurysms treated in our clinic during the same period (n 446). Results: DACA aneurysms accounted for 4% of all intracranial aneurysms. They were smaller (median, 5,5 versus 9 mm) We found only one case with associated aneurysms (5,5%). DACA aneurysms presented more often with intracerebral hematomas (39% versus 26%) than ruptured aneurysms in general. Their microsurgical treatment showed the same complication rates (treatment morbidity, 15%) as for other ruptured aneurysms in literature. Their mortality rate was lower (11% versus 24%). Conclusion: Despite their specific anatomic features, and particular surgical technique, with modern treatment methods, ruptured DACA aneurysms have the same favorable outcome and lower mortality as ruptured aneurysms in general.

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Section: Clinical Outcomementioning

confidence: 97%

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Gherasim¹,

Gyorki²,

Bălaşa³

2017

Romanian Neurosurgery

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“…Ugur et al (78) proposed a new classification system. The CmA was either defined as typical, atypical or absent.…”

Section: Callosomarginal Arterymentioning

confidence: 99%

“…An atypical CmA was observed when there was only a very short artery coursing in the cingulate sulcus. Two symmetrical callosomarginal arteries can also be present in the same hemisphere (78). A typical CmA has a longer course compared to the two symmetrical atypical callosomarginal arteries and usually originates from the A3 segment (28,62,78).…”

Section: Callosomarginal Arterymentioning

confidence: 99%

“…The A3 segment (also referred to as the precallosal part) curves around the genu, and the A4 segment (also referred to as the supracallosal section) usually runs in the callosal sulcus and almost reaches the splenium (3, 58,62). The A5 segment (cortical branches) varies considerably; it is therefore difficult to describe a standard arterial pattern (78). The two basic configurations of the ACA are determined by the presence or absence of the CmA (6, 58,64).…”

mentioning

confidence: 99%

“…The CmA is also not always present and therefore it is preferable to classify the pericallosal artery as the segment distal to the AcoA (28,62). The callosomarginal artery has been observed in 40.0% to 93.4% of specimens (6,17,28,34,44,54,62,64,65,68,69,78). The variability of the absence or presence of the CmA can be due to the different definitions used for this artery (65).…”

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confidence: 99%

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Review of the anatomy of the distal anterior cerebral artery and its anomalies

Cilliers

Page²

2015

Turkish Neurosurgery

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SegmentationVarious authors have used different terms to describe the segments of the ACA (36,64,68). It can be divided into proximal and distal segments, or pre-and postcommunicating segments. The pericallosal artery is distal to the A1 segment and consists of several segments that can be divided according to its relationship with the corpus callosum. The A2 segment (also referred to as the infracallosal section) runs vertically █ INTRODUCTION T he cerebral cortex is primarily supplied by the anterior, middle and posterior cerebral arteries. The anatomy of the anterior cerebral artery (ACA) varies considerably and this complicates the description of the ACA and its branches. The segmentation of the ACA is mostly described similarly by different authors, although the relationship of the pericallosal (PrcA) and callosomarginal arteries (CmA) is not agreed upon (78).The anterior cerebral artery (ACA) varies considerably and this complicates the description of the normal anatomy. The segmentation of the ACA is mostly agreed on by different authors, although the relationship of the pericallosal and callosomarginal arteries (CmA) is not agreed upon. The two basic configurations of the ACA are determined by the presence or absence of the CmA.The diameter, length and origin of the cortical branches have been measured and described by various authors and display great variability. Common anomalies of the ACA include the azygos, bihemispheric, and median anterior cerebral arteries.A pilot study was done on 19 hemispheres to assess the variation of the branches of the ACA. The most common variations included absence and duplication. The inferior internal parietal artery and the CmA were most commonly absent and the paracentral lobule artery was the most frequently duplicated (36.8%). The inferior internal parietal artery originated from the posterior cerebral artery in 40.0% and this was the most unusual origin observed.It is important to be aware of the possibility of variations since these variations can have serious clinical implications. The knowledge of these variations can be helpful to clinicians and neurosurgeons. The aim of this article is to review the anatomy and variations of the anterior cerebral artery, as described in the literature. This was also compared to the results from a pilot study.

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Callosal branches of the anterior cerebral artery: An anatomical report

et al. 2008

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Although the morphology of the corpus callosum is well defined, the arterial supply of this structure has not been comprehensively studied. To elucidate this further, 40 cerebral hemispheres from 30 adult cadaveric brains were obtained. The anterior cerebral arteries were cannulated and injected with red latex. The following were observed and documented: (1) the number, diameter, and course of the arteries supplying the corpus callosum; (2) the territories vascularized by these arteries; (3) any variations of the callosal arteries. Short callosal arteries were present in 58 hemispheres (96.6%) and supplied the superficial surface of the corpus callosum along its midline and were a primary arterial source to this structure. Long callosal arteries were found in 28 hemispheres (46.6%) and contributed to the pial plexus. The cingulocallosal arteries were present in all hemispheres and supplied the corpus callosum, cingulate gyrus, and also contributed to the pericallosal pial plexus. The recurrent cingulocallosal arteries were present in 17 hemispheres (28.3%) and also contributed to the pericallosal pial plexus. The median callosal artery, an anatomical variation, was present in 10 brains (33.3%). This vessel supplied the corpus callosum and the cingulate gyrus. The aim of the present study was to provide a detailed description of the arteries supplying the corpus callosum for those who encounter these vessels radiologically or surgically.

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A neurosurgical view of anatomical variations of the distal anterior cerebral artery: an anatomical study

Abstract: In each hemisphere, the vascularization pattern of the distal ACA is different to a greater or lesser extent. An awareness of this fact will contribute significantly to surgical interventions.

Cited by 46 publications

References 30 publications

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Single center experience and technical nuances in the treatment of distal anterior cerebral artery aneurysms

Review of the anatomy of the distal anterior cerebral artery and its anomalies

Callosal branches of the anterior cerebral artery: An anatomical report

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