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A distal anterior cerebral artery tripod branching to a bihemispheric pericallosal artery

  • Anatomic Variations
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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.

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Theodosis Kalamatianos, Christos Chrissicopoulos & George Stranjalis

  2. Department of Anatomy, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias str., Goudi, 11527, Athens, Greece

    Ioannis Antonopoulos & Maria Piagkou

  3. Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Konstantinos Natsis

Authors
  1. Theodosis Kalamatianos
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  2. Ioannis Antonopoulos
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  3. Maria Piagkou
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  4. Konstantinos Natsis
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  5. Christos Chrissicopoulos
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  6. George Stranjalis
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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.

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Correspondence to Maria Piagkou.

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Ethical approval was taken for the University Research Committee.

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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

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  • DOI: https://doi.org/10.1007/s00276-021-02879-3

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