Abstract
The anterior cerebral artery (ACA) branching pattern may be particularly complex and variant including bifurcations, trifurcations or quadrifurcations, thus leading to typical or atypical vessels. The bihemispheric ACA (BhACA) variant crosses the midline to supply the contralateral hemisphere. The current case highlights a left-sided ACA trifurcation into a bihemispheric pericallosal artery, and two ipsilateral atypical arteries: a callosomarginal artery of short course and a left-sided pericallosal artery of an aberrant course into the cingulate sulcus. The depicted trifurcation was characterized as a distal ACA tripod. The bihemispheric branch supplied the contralateral pericallosal area and coursed into the cingulate sulcus. Deviations from the typical ACA pattern, especially when they coexist are quite rare and may complicate neurosurgical approaches or raise diagnostic difficulties. The BhACA may be implicated in aneurysm formation and bilateral ischemia after its occlusion. Knowledge of such variants, as well as awareness of the complications they may be related to, is of great significance.
Similar content being viewed by others
Data availability
All data and material are available.
Code availability
Not applicable.
References
Cardon A, Aillet S, Jarno P, Bensalah K, Le Du J, Idrissi A, Kerdiles Y (2001) Endarteriectomy of the femoral tripod: long-term results and analysis of failure factors. Ann Chir 126:777–782
Cavalcanti DD, Albuquerque FC, Silva BF, Spetzler RF, Preul MC (2010) The anatomy of the callosomarginal artery: applications to microsurgery and endovascular surgery. Neurosurgery 66:602–610
Cilliers K, Page BJ (2016) Detailed description of the anterior cerebral artery anomalies observed in a cadaver population. Ann Anat 208:1–8
Cilliers K, Page BJ (2016) Review of the anatomy of the distal anterior cerebral artery and its anomalies. Turk Neurosurg 26:653–661
Dimmick SJ, Faulder KC (2009) Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics 29:1027–1043
Foreman PM, Griessenauer CJ, Deveikis JP, Harrigan MR (2016) Internal carotid artery and the anterior cerebral circulation. In: Tubbs RS, Shoja MM, Loukas M (eds) Bergman’s comprehensive encyclopedia of human anatomic variation. Wiley Blackwell, Hoboken, pp 455–456
Kakou M, Destrieux C, Velut S (2000) Microanatomy of the pericallosal arterial complex. J Neurosurg 93:667–675
Laitinen L, Snelmann A (1968) Aneurysms of the pericallosal artery. A study of 14 cases verified angiographically and treated mainly by direct surgical attack. J Neurosurg 17:447–458
Lehecka M, Porras M, Dashti R, Niemelä M, Hernesniemi JA (2008) Anatomic features of distal anterior cerebral artery aneurysms: a detailed angiographic analysis of 101 patients. Neurosurgery 63:219–228
Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–261
Perlmutter D, Rhoton A (1978) Microsurgical anatomy of the distal anterior cerebral artery. J Neurosurg 49:204–228
Pinal-Garcia DF, Nuno-Guzman CM, Gonzalez-Gonzalez ME, Ibarra-Hurtado TR (2018) The celiac trunk and its anatomical variations: a cadaveric study. J Clin Med Res 10:321–329
Türe U, Yaşargil M, Krisht A (1996) The arteries of the corpus callosum: a microsurgical anatomic study. Neurosurgery 39:1075–1084
Ugur HC, Kahilogullari G, Esmer AF, Comert A, Odabasi AB, Tekdemir I, Elhan A, Kanpolat Y (2006) A neurosurgical view of anatomical variations of the distal anterior cerebral artery: an anatomical study. J Neurosurg 104:278–284
Funding
No funding was received.
Author information
Authors and Affiliations
Contributions
TK: project development, dissections’ photographs, manuscript writing and editing; IA: project development, data collection and analysis, dissection, manuscript writing and editing; MP: data collection, data analysis, manuscript writing, editing and final revision; KN: manuscript editing; CC: manuscript editing; and GS: manuscript editing. All the authors approved the final draft of the paper, as well as its revised form.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Ethical approval
Ethical approval was taken for the University Research Committee.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kalamatianos, T., Antonopoulos, I., Piagkou, M. et al. A distal anterior cerebral artery tripod branching to a bihemispheric pericallosal artery. Surg Radiol Anat 44, 303–306 (2022). https://doi.org/10.1007/s00276-021-02879-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-021-02879-3