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. 2022 Sep 28;58(10):1365.
doi: 10.3390/medicina58101365.

Transcallosal and Pericallosal Courses of the Anterior Cerebral Artery

Dragoş Ionuţ Mincă  1 , Mugurel Constantin Rusu  1 , Petrinel Mugurel Rădoi  2   3 , Sorin Hostiuc  4 , Corneliu Toader  2   3
Affiliations

Transcallosal and Pericallosal Courses of the Anterior Cerebral Artery

Dragoş Ionuţ Mincă et al. Medicina (Kaunas). .

Abstract

(1) Background: The anterior cerebral artery (ACA) has a precommunicating A1 segment, followed by a postcommunicating A2 segment. Anatomically, after it sends off from the callosomarginal artery (CMA), it continues as the pericallosal artery (PCalA). A detailed pattern of the anatomical variations of the PCalA are needed for practical reasons. (2) Methods: There were 45 retrospectively documented Computed Tomography Angiograms of 32 males and 13 females. (3) Results: In 90 sides, eleven different types of PCalA were documented: type 1: normal origin, above the genu of the corpus callosum (CC) (51.11%); type 2: low origin, below the rostrum of the CC (8.88%); type 3: late origin, above the body of the CC (3.33%); type 4, initial transcallosal course (3.33%); type 5, duplicated PCalA (1.11%); type 6, azygos PCalA (2.22%); type 7, absent PCalA (CMA type of ACA) (7.78%); type 8: CMA continued as PCalA (5.56%); type 9: PCalA continued as the cingular branch (1.11%); type 10: PCalA type of ACA, absent CMA (14.44%); type 11: triple PCalA, with an added median artery of the CC (1.11%). Different types of CMA were also documented: type 0, absent CMA (17.78%); type 1, CMA with frontoparietal distribution (45.56%); type 2, CMA with parietal distribution (22.22%); type 3, low origin of CMA, either from A1, or from A2 (8.88%); type 4, CMA continued as PCalA (5.56%). Ipsilateral combinations of PCalA and CMA types were classified as types A-P. In 33/45 cases (73.3%), the bilateral asymmetry of the combined anatomical patterns of PCalA and CMA was documented. Additional rare variations were found: (a) huge fenestration of A2; (b) bihemispheric ACAs (6/45 cases); (c) twisted arteries within the interhemispheric fissure. (4) Conclusions: The PCalA and CMA are anatomically diverse and unpredictable. Therefore, they should be documented on a case-by-case basis before surgical or endovascular approaches.

Keywords: anterior cerebral artery; corpus callosum; internal carotid artery; interventional radiology; neurosurgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Three-dimensional volume renderings of different types of different branching types of the anterior cerebral arteries (ACAs) into the pericallosal (PCalA) and callosomarginal (CMA) arteries. (A) Left antero-lateral view: 1 A2 segments of the ACAs; 2. type 1 PCalAs; 3. type 1 CMAs. (B) Right lateral view: 1. A2 segments of the ACAs; 2. type 10 right PCalA (PCalA type of ACA); 3. type 4 left CMA, at the level of the cingulate sulcus; 4. type 8 left PCalA. (C) Right lateral view: 1. A2 segments of the ACAs; 2. left type 1 CMA; 3. left type 1 PCalA; 4. right type 1 CMA, type 7 (absent) right PCalA. (D) Right lateral view: 1. A2 segments of the ACAs; 2. type 3b of the right CMA; 3. type 2b of the right PCalA. (E) Right antero-lateral view: 1. A2 segments of the ACAs; 2. type 2a of the left PCalA; 3. type 3a of the left CMA; 4. type 3 of the right PCalA; 5. type 2 right CMA. (F) Right lateral view: 1. A2 segment of the left ACA; 2. left type 1 PCalA; 3. left type 1 CMA; 4. type 2a right PCalA; 5. type 3a right CMA.
Figure 2
Figure 2
Type 4, pericallosal artery coursing through the corpus callosum. (A) Three-dimensional volume rendering, left lateral view; (B) Mediosagittal slice through the corpus callosum. (C) Axial slice through the corpus callosum: 1. anterior cerebral arteries; 2. left callosomarginal artery; 3. transcallosal course of the left pericallosal artery; 4. right pericallosal artery; 5. genu of corpus callosum; 6. body of corpus callosum.
Figure 3
Figure 3
Type 4 pericallosal arteries coursing through the corpus callosum; (A) Three-dimensional volume rendering, left lateral view; (B) Mediosagittal slice through the corpus callosum; (C) Coronal slice through the corpus callosum: 1. left anterior cerebral artery; 2. right anterior cerebral artery; 3. right pericallosal artery; 4. right callosomarginal artery; 5. transcallosal course of the left pericallosal artery; 6. left callosomarginal artery; 7. rostrum of corpus callosum; 8. body of corpus callosum.
Figure 4
Figure 4
Three-dimensional volume renderings of different types of different branching types of the anterior cerebral arteries (ACAs) into the pericallosal (PCalA) and callosomarginal (CMA) arteries. (A) Right lateral view: 1. A2 segments of the ACAs; 2. type 1 right CMA; 3. type 1 left CMA; 4. type 6 type 6 PCalA (azygos PCalA); 5. right PCalA; 6. left PCalA. (B) Right lateral view: 1. A2 segments of the ACAs; 2. type 5 (duplicated) right PCalA. (C) Right lateral view: 1. A2 segments of the ACAs; 2. left CMA; 3. left PCalA; 4. type 9 right PCalA; 5. right cingular branch. (D) Left lateral view, type 11—triple PCalA: 1. A1 segment of bihemispheric right ACA; 2. median callosal artery; 3. left A2 segment; 4. right bihemispheric A2 segment; 5. left CMA; 6. right CMA; 7. left PCalA; 8. right PCalA.
Figure 5
Figure 5
Three-dimensional volume rendering, right lateral view of the anterior cerebral arteries (ACAs): 1. right internal carotid artery; 2. right middle cerebral artery; 3. hypoplastic A1 segment of the right ACA; 4. A1 segment of the bihemispheric left ACA; 5. right A2 segment; 6. left A2 segment; 7. bilateral orbitofrontal branches; 8. right callosomarginal artery; 9. left callosomarginal artery; 10. left pericallosal artery; 11. right cingular branch; 12. right pericallosal artery. A huge fenestration of the right A2 segment consists of a postero-lateral arm (arrowhead) and an antero-medial one (double-headed arrow). The A2 segments are twisted in the interhemispheric fissure.
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