Anterior Cerebral Artery
Branches
ACA Segments |
Location |
Branches |
A1 |
Pre-communicating |
Lenticulostriate, recurrent artery of Huebner |
A2 |
From Acom to callosomarginal |
Orbitofrontal, frontopolar, |
A3 |
Continuation as pericallosal artery after callosomarginal origin |
Callosomarginal Continues as pericallosal |
A4 |
Small cortical branches |
|
Variants
Variant |
Description |
A1 segment hypoplasia |
Both A2 segment arise from one side – in 10% |
Azygous ACA |
Single A2 segment supplying both sides – in 1% |
Absent Acom |
Limited collaterals from the other side – in 20% |
Persistent Olfactory a |
ACA makes a long turn in olfactory groove before giving pericallosal a. |
Stroke Syndromes
Occluded artery |
Occlusion syndrome |
Complete ACA occlusion |
Weakness/sensory: Mainly leg, mild face/arm weakness can be involved due to artery of Huebner. Behavioral: apathy, abulia (medial frontal), disinhibition (inferior frontal) Urine incontinence |
Recurrent artery of Huebner |
Arm and face weakness, abulia, chorea NB: originates after Acom artery origin, can be mistakenly clipped |
Callosomarginal |
SMA syndrome (contralateral apraxia, hypotonia and mutism) NB: Patient may not be able to move their leg on commands but able to stand (apraxia) |
Pericallosal |
Leg > arm weakness, early onset spasticity NB: Spasticity as a presenting sign can be seen due to loss of cortical inhibition on reticulospinal tract |