Surgical anatomy of the proximal anterior cerebral artery

Abstract
This study of proximal anterior cerebral arteries in the normal human provides a clearer basis for strategry in aneurysm surgery. Patterns of branch origin, their subarachnoid course and parenchymal distribution are described. 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 of named vessels. With this anatomical information one can avoid interruption of the blood supply to vital structures when dealing with the anterior cerebral artery and its branches.