The diverse morphological expression of the anterior cerebral artery (ACA), described in several population groups, generates a complex spectrum of clinical signs when embolic or hemorrhagic strokes occur. This study evaluated the ACA and its branches in 162 cerebral hemispheres extracted from corpses at the Institute of Legal Medicine in Bucaramanga, Colombia. The proximal segments of the internal carotid and vertebral arteries were bilaterally perfused with semisynthetic resin dyed with red-colored minerals. The qualitative and morphometric characteristics of the ACA and its branches were recorded. The length of the A1 segment was 12.4±2.5 mm, with a diameter 2.4±0.6 mm. The medial orbitofrontal branch (MOF) originated from the A2 segment in 144 cases (93.5%), and in 41 specimens (26.6%), it formed common trunks with the frontopolar branch (FP) or with the anterior medial frontal branch (AMF). The length and diameter of the marginal callosal branch (MC) were 59.7±18.8 mm and 1.6±0.5 mm, respectively. The sixteen cases (10.4%) of observed medial frontal branches stemmed from the ACA and not from the MC. In thirty-three cases (21.4%), the branch of the paracentral lobule (PcL) emerged from the A3 segment; in 81 samples (52.6%) from the MC; and in 40 (26%) from the A4 segment. This study found great variability in the emergence of the ACA branches, especially the MC, the MF, and the PcL. Knowing the origin, unique or branched pathways, and territories irrigated by the ACA and its branches enriches the diagnosis, management, and interventions when these structures are compromised in clinical events.
Read full abstract