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| Caption = Outer surface of cerebral hemisphere, showing areas supplied by cerebral arteries. (Blue is region supplied by anterior cerebral artery.)
| Caption = Outer surface of cerebral hemisphere, showing areas supplied by cerebral arteries. Areas supplied by the anterior cerebral artery are shown in blue.
| Image2 = Circle of Willis en.svg
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| Caption2= Medial surface of cerebral hemisphere. Areas supplied by the anterior cerebral artery are shown in blue.
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| Caption2= The [[circle of Willis|arterial circle]] and arteries of the brain. The '''anterior cerebral arteries''' (top of figure) arise from the trifurcations of the [[internal carotid artery|internal carotid arteries]] into the '''anterior cerebral artery''', [[middle cerebral artery]] and [[posterior communicating artery]] on each side.
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The '''anterior cerebral artery''' ('''ACA''') is one of a pair of arteries on [[Human brain|the brain]] that supplies oxygenated blood to most medial portions of the [[frontal lobe]]s and [[superior medial parietal]] lobes. The two anterior cerebral arteries arise from the [[internal carotid artery]] and are part of the [[Circle of Willis]].
The '''anterior cerebral artery''' ('''ACA''') is one of a pair of arteries on [[Human brain|the brain]] that supplies oxygenated blood to most medial portions of the [[frontal lobe]]s and [[superior medial parietal]] lobes. The two anterior cerebral arteries arise from the [[internal carotid artery]] and are part of the [[circle of Willis]].


The left and right anterior cerebral arteries are connected by the [[anterior communicating artery]].
The left and right anterior cerebral arteries are connected by the [[anterior communicating artery]].


==Structure==
==Structure==
⚫
[[File:Sobotta.3.1909.549.png|thumb|right|Arteries of the brain. Anterior cerebral artery labeled at the left]]
The ACA is classified into 5 segments with the smaller branches from the ACA "callosal" arteries (supracallosal) considered as the '''A4''' and '''A5''' segments:<ref name=Kray>{{Citation |title=Cerebral Angiography |first= Hugo |last=Krayenbühl |first2= Mahmut Gazi |last2=Yaşargil |first3= Peter |last3=Huber |first4= George |last4=Bosse |year=1982 |publisher=Thieme |pages=79–91|isbn=978-0-86577-067-6 |url=http://books.google.com/?id=0e6YO3IEbt0C&dq}}</ref>
The anterior cerebral artery is divided into 5 segments. Its smaller branches: the callosal (supracallosal) arteries are considered as the '''A4''' and '''A5''' segments.<ref name=Kray>{{Citation |title=Cerebral Angiography |first= Hugo |last=Krayenbühl |first2= Mahmut Gazi |last2=Yaşargil |first3= Peter |last3=Huber |first4= George |last4=Bosse |year=1982 |publisher=Thieme |pages=79–91|isbn=978-0-86577-067-6 |url=http://books.google.com/?id=0e6YO3IEbt0C&dq}}</ref>
*'''A1''': this segment originates from the internal carotid artery and extends to the ''anterior communicating artery'' (AComm). The ''anteromedial central'' (medial lenticulostriate) arteries arise from this segment as well as the AComm, which irrigate the [[caudate nucleus]] and the anterior limb of the [[internal capsule]]
*'''A1''' originates from the internal carotid artery and extends to the ''anterior communicating artery'' (AComm). The ''anteromedial central'' (medial lenticulostriate) arteries arise from this segment as well as the AComm, which irrigates the [[caudate nucleus]] and the anterior limb of the [[internal capsule]]
*'''A2''': this segment extends from the AComm to the bifurcation forming the ''pericallosal'' and ''callosomarginal arteries''. The ''[[recurrent artery of Heubner]]'' (distal medial striate artery), which irrigate the internal capsule, usually arises at the beginning of this segment near the AComm. 4 branches arise from this segment, the:
*'''A2''' extends from the AComm to the bifurcation forming the ''pericallosal'' and ''callosomarginal arteries''. The ''[[recurrent artery of Heubner]]'' (distal medial striate artery), which irrigate the internal capsule, usually arises at the beginning of this segment near the AComm. Two branches arise from this segment:
**''Orbitofrontal artery'' (medial frontal basal): Arises first a small distance away from the AComm
**''Frontopolar artery'' (polar frontal): Arises after the ''orbitofrontal'' close to when A2 curves posteriorly over the [[corpus callosum]]. Could also originate from the ''callosal marginal''.
**''Orbitofrontal artery'' (medial frontal basal): Arises a small distance away from the AComm
*'''A3''': Also termed the ''pericallosal artery'' this is one of (or the only) the main terminal branches of the ACA, which extends posteriorly in the pericallosal sulcus to form the ''internal parietal arteries'' (superior, inferior) and the ''precuneal artery''. This artery may form an [[anastomosis]] with the ''[[posterior cerebral artery]]''.
**''Frontopolar artery'' (polar frontal): Arises after the ''orbitofrontal'', close to the curvature of A2 over the [[corpus callosum]]. It can also originate from the ''callosal marginal''.
*'''A3''', also termed the ''pericallosal artery'', is one of the (or the only) main terminal branches of the ACA, which extends posteriorly in the pericallosal sulcus to form the ''internal parietal arteries'' (superior, inferior) and the ''precuneal artery''. This artery may form an [[anastomosis]] with the ''[[posterior cerebral artery]]''.
**''Callosal marginal artery'': A commonly present terminal branch of the ACA, which bifurcates from the ''pericallosal artery''. This artery in turn branches into the ''medial frontal arteries'' (Anterior, Intermediate, Posterior), and the ''paracentral artery'', with the [[cingulate]] branches arising throughout its length. Depending on [[anatomical variation]], the ''callosal marginal artery'' may be none discrete or not be visible. In the latter case, the branches mentioned will originate from the ''pericallosal artery''. In a study of 76 hemispheres, the artery was present in only 60% of the cases.<ref>{{Citation|first=MARCO A. STEFANI |last=SCHNEIDER |first2=ANTONIO C. H. |last2=MARRONE |first3=ANTONIO G. |last3=SEVERINO |first4=ANDREA P. |last4=JACKOWSKI |first5=M. CHRISTOPHER |last5=WALLACE |title=Anatomic Variations of Anterior Cerebral Artery Cortical Branches |journal=Clinical Anatomy|issue=13 |year=2000 |pages=321–236}}</ref> Angiography studies cite that the vessel can be seen 67% <ref name=Kray/> or 50%<ref>{{Citation| title=Diagnostic Cerebral Angiography |first= Anne G. |last=Osborn |first2= John M. |last2=Jacobs |year=1999 |publisher=Lippincott Williams & Wilkins |isbn=978-0-397-58404-8 |pages=143–144}}</ref> of the time.
**''Callosal marginal artery'': A commonly present terminal branch of the ACA, which bifurcates from the ''pericallosal artery''. This artery in turn branches into the ''medial frontal arteries'' (anterior, intermediate, posterior), and the ''paracentral artery'', with the [[cingulate]] branches arising throughout its length. Depending on [[anatomical variation]], the ''callosal marginal artery'' may be none discrete or not be visible. In the latter case, the branches mentioned will originate from the ''pericallosal artery''. In a study of 76 hemispheres, the artery was present in only 60% of the cases.<ref>{{Citation|first=MARCO A. STEFANI |last=SCHNEIDER |first2=ANTONIO C. H. |last2=MARRONE |first3=ANTONIO G. |last3=SEVERINO |first4=ANDREA P. |last4=JACKOWSKI |first5=M. CHRISTOPHER |last5=WALLACE |title=Anatomic Variations of Anterior Cerebral Artery Cortical Branches |journal=Clinical Anatomy|issue=13 |year=2000 |pages=321–236}}</ref> Angiography studies cite that the vessel can be seen 67% <ref name=Kray/> or 50%<ref>{{Citation| title=Diagnostic Cerebral Angiography |first= Anne G. |last=Osborn |first2= John M. |last2=Jacobs |year=1999 |publisher=Lippincott Williams & Wilkins |isbn=978-0-397-58404-8 |pages=143–144}}</ref> of the time.


==Function==
===Development===
The anterior cerebral artery develops from a primitive anterior division of the [[internal carotid artery]] that initially supplies the optic and olfactory regions. This anterior division, which appears at the twenty-eighth day of development, also forms the [[middle cerebral artery]] and the [[anterior choroidal artery]]. The anterior cerebral arteries grow toward each other and form the [[anterior communicating artery]] at the 21–24&nbsp;mm stage of the [[embryo]].<ref name=menshawi>{{cite journal|last1=Menshawi|first1=K|last2=Mohr|first2=JP|last3=Gutierrez|first3=J|title=A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply.|journal=Journal of Stroke|date=May 2015|volume=17|issue=2|pages=144-58|doi=10.5853/jos.2015.17.2.144|pmid=26060802|pmc=4460334}}</ref>
Areas supplied by the anterior cerebral artery include:{{Citation needed|date=February 2007}}


===Variation===
# The medial surface of the [[frontal lobe]] by the medial orbito-frontal artery, and [[parietal lobe|parietal]] lobes
The anterior cerebral artery shows considerable variation. In a study made using [[Magnetic resonance angiography|MRA]], the most common variation was an underdeveloped A1 segment (5.6%), followed by the presence of an extra A2 segment (3%). In 2% of cases there was only one A2 segment.<ref name=uchino>{{cite journal|last1=Uchino|first1=A|last2=Nomiyama|first2=K|last3=Takase|first3=Y|last4=Kudo|first4=S|title=Anterior cerebral artery variations detected by MR angiography.|journal=Neuroradiology|date=September 2006|volume=48|issue=9|pages=647-52|pmid=16786350|url=http://link.springer.com/article/10.1007%2Fs00234-006-0110-3}}</ref>
# The anterior four- fifths of the [[corpus callosum]]

# Approximately 1&nbsp;inch of the lateral surfaces of frontal and parietal lobes, next to the [[medial longitudinal fissure]]
==Function==
# Anterior portions of the [[basal ganglia]] and [[internal capsule]]
The anterior cerebral artery supplies a part of the frontal lobe, specifically its medial surface and the superior border. It also supplies the anterior four–fifths of the [[corpus callosum]], and provides blood to deep structures such as the anterior limb of the [[internal capsule]], part of the [[caudate nucleus]], and the anterior part of the [[globus pallidus]].<ref name=adams>{{cite book|last1=Ropper|first1=A.|last2=Samuels|first2=M.|last3=Klein|first3=J.|title=Adams and Victor's Principles of Neurology|date=2014|publisher=McGraw-Hill|isbn=978-0071794794|pages=798|edition=10th}}</ref>
# [[Olfactory bulb]] and tract


==Clinical relevance==
==Clinical relevance==


===Occlusion===
===Occlusion===
{{main|Anterior cerebral artery syndrome}}
Occlusion of the anterior cerebral artery may result in the following defects:<ref>Harrison's Principles of Internal Medicine 18th Edition vol. 2 Chapter 370, Cerebrovascular Diseases,page 3286, Fig 370-8</ref>
If stroke occurs prior to the anterior communicating artery it is usually well tolerated secondary to collateral circulation.
If stroke occurs prior to the anterior communicating artery it is usually well tolerated secondary to collateral circulation. After occlusion of A2 segment, the following signs and symptoms may be noted:<ref name="harrison">{{cite book|last1=Longo|first1=D|last2=Fauci|first2=A|last3=Kasper|first3=D|last4=Hauser|first4=S|last5=Jameson|first5=J|last6=Loscalzo|first6=J|title=Harrison's Principles of Internal Medicine|date=2012|publisher=McGraw-Hill|location=New York|page=3286|isbn=978-0071748896|edition=18th}}</ref>

Occlusion of A2 segment(Post communal segment of Anterior cerebral artery) the following signs and symptoms may be noted.
# [[Paralysis]] or weakness of the [[contralateral]] foot and leg due to involvement of Motor leg area
* [[Paralysis]] or weakness of the [[contralateral]] foot and leg due to involvement of motor leg area
# Cortical [[Sensory loss]] in the contralateral foot and leg
* Cortical [[sensory loss]] in the contralateral foot and leg
# [[Gait apraxia]] Impairment of gait and stance
* [[Gait apraxia]] (impairment of gait and stance)
# [[Abulia]] akinetic mutism, slowness and lack of spontaneity
* [[Abulia]], akinetic mutism, slowness and lack of spontaneity
# [[Urinary incontinence]] which usually occurs with [[wiktionary:bilateral|bilateral]] damage in the acute phase
* [[Urinary incontinence]] which usually occurs with [[wiktionary:bilateral|bilateral]] damage in the acute phase
# Frontal Cortical release reflexes: Contralateral [[grasp reflex]], [[sucking reflex]], [[gegenhalten]](paratonic rigidity)
* [[Frontal release sign|Frontal cortical release reflexes]]: Contralateral [[grasp reflex]], [[sucking reflex]], [[Paratonia|paratonic rigidity]]


==Additional images==
==Additional images==
<gallery>
<gallery>
File:Circle of Willis 5.jpg|Anterior cerebral artery
File:Circle of Willis 5.jpg|Anterior cerebral artery
⚫
File:Sobo 1909 3 548.png|Cerebral arteries seen from beneath. Anterior cerebral artery visible at centre.
⚫
Image:Gray518.png|Medial surface of cerebral hemisphere, showing areas supplied by cerebral arteries. Areas supplied by the anterior cerebral artery are shown in blue.
⚫
File:Circle of Willis en.svg|The [[circle of Willis|arterial circle]] and arteries of the brain. The anterior cerebral arteries (top of figure) arise from the trifurcations of the [[internal carotid artery|internal carotid arteries]].
File:CerebralCirculationAnteriorView.svg|Anterior view of cerebral circulation, including rough courses of A1, A2, and A3 with pericallosal and supracallosal branches.
⚫
File:Sobotta.3.1909.549.png|Cerebral arteries seen in mid-line. Anterior cerebral artery visible at centre.
⚫
File:Sobo 1909 3 548.png|Cerebral arteries seen from beneath. Anterior cerebral artery visible at centre.
</gallery>
</gallery>


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{{Anatomy-terms}}
{{Anatomy-terms}}
* [[Cerebral circulation]]
* [[Cerebral circulation]]
* [[Middle Cerebral Artery]]
* [[Middle cerebral artery]]


==References==
==References==
{{reflist|2}}
{{reflist}}


==External links==
==External links==

Revision as of 08:48, 2 September 2015

Anterior cerebral artery
Outer surface of cerebral hemisphere, showing areas supplied by cerebral arteries. Areas supplied by the anterior cerebral artery are shown in blue.
Medial surface of cerebral hemisphere. Areas supplied by the anterior cerebral artery are shown in blue.
Details
Sourceinternal carotid artery
Veincerebral veins
Suppliescerebrum
Identifiers
Latinarteria cerebri anterior
MeSHD020771
TA98A12.2.07.022
TA24502
FMA50028
Anatomical terminology

The anterior cerebral artery (ACA) is one of a pair of arteries on the brain that supplies oxygenated blood to most medial portions of the frontal lobes and superior medial parietal lobes. The two anterior cerebral arteries arise from the internal carotid artery and are part of the circle of Willis.

The left and right anterior cerebral arteries are connected by the anterior communicating artery.

Structure

Arteries of the brain. Anterior cerebral artery labeled at the left

The anterior cerebral artery is divided into 5 segments. Its smaller branches: the callosal (supracallosal) arteries are considered as the A4 and A5 segments.[1]

  • A1 originates from the internal carotid artery and extends to the anterior communicating artery (AComm). The anteromedial central (medial lenticulostriate) arteries arise from this segment as well as the AComm, which irrigates the caudate nucleus and the anterior limb of the internal capsule
  • A2 extends from the AComm to the bifurcation forming the pericallosal and callosomarginal arteries. The recurrent artery of Heubner (distal medial striate artery), which irrigate the internal capsule, usually arises at the beginning of this segment near the AComm. Two branches arise from this segment:
    • Orbitofrontal artery (medial frontal basal): Arises a small distance away from the AComm
    • Frontopolar artery (polar frontal): Arises after the orbitofrontal, close to the curvature of A2 over the corpus callosum. It can also originate from the callosal marginal.
  • A3, also termed the pericallosal artery, is one of the (or the only) main terminal branches of the ACA, which extends posteriorly in the pericallosal sulcus to form the internal parietal arteries (superior, inferior) and the precuneal artery. This artery may form an anastomosis with the posterior cerebral artery.
    • Callosal marginal artery: A commonly present terminal branch of the ACA, which bifurcates from the pericallosal artery. This artery in turn branches into the medial frontal arteries (anterior, intermediate, posterior), and the paracentral artery, with the cingulate branches arising throughout its length. Depending on anatomical variation, the callosal marginal artery may be none discrete or not be visible. In the latter case, the branches mentioned will originate from the pericallosal artery. In a study of 76 hemispheres, the artery was present in only 60% of the cases.[2] Angiography studies cite that the vessel can be seen 67% [1] or 50%[3] of the time.

Development

The anterior cerebral artery develops from a primitive anterior division of the internal carotid artery that initially supplies the optic and olfactory regions. This anterior division, which appears at the twenty-eighth day of development, also forms the middle cerebral artery and the anterior choroidal artery. The anterior cerebral arteries grow toward each other and form the anterior communicating artery at the 21–24 mm stage of the embryo.[4]

Variation

The anterior cerebral artery shows considerable variation. In a study made using MRA, the most common variation was an underdeveloped A1 segment (5.6%), followed by the presence of an extra A2 segment (3%). In 2% of cases there was only one A2 segment.[5]

Function

The anterior cerebral artery supplies a part of the frontal lobe, specifically its medial surface and the superior border. It also supplies the anterior four–fifths of the corpus callosum, and provides blood to deep structures such as the anterior limb of the internal capsule, part of the caudate nucleus, and the anterior part of the globus pallidus.[6]

Clinical relevance

Occlusion

Main article: Anterior cerebral artery syndrome

If stroke occurs prior to the anterior communicating artery it is usually well tolerated secondary to collateral circulation. After occlusion of A2 segment, the following signs and symptoms may be noted:[7]

Additional images

  • Anterior cerebral artery
    Anterior cerebral artery
  • Cerebral arteries seen from beneath. Anterior cerebral artery visible at centre.
    Cerebral arteries seen from beneath. Anterior cerebral artery visible at centre.
  • The arterial circle and arteries of the brain. The anterior cerebral arteries (top of figure) arise from the trifurcations of the internal carotid arteries.
    The arterial circle and arteries of the brain. The anterior cerebral arteries (top of figure) arise from the trifurcations of the internal carotid arteries.

See also

This article uses anatomical terminology.

References

  1. ^ a b Krayenbühl, Hugo; Yaşargil, Mahmut Gazi; Huber, Peter; Bosse, George (1982), Cerebral Angiography, Thieme, pp. 79–91, ISBN 978-0-86577-067-6
  2. ^ SCHNEIDER, MARCO A. STEFANI; MARRONE, ANTONIO C. H.; SEVERINO, ANTONIO G.; JACKOWSKI, ANDREA P.; WALLACE, M. CHRISTOPHER (2000), "Anatomic Variations of Anterior Cerebral Artery Cortical Branches", Clinical Anatomy (13): 321–236
  3. ^ Osborn, Anne G.; Jacobs, John M. (1999), Diagnostic Cerebral Angiography, Lippincott Williams & Wilkins, pp. 143–144, ISBN 978-0-397-58404-8
  4. ^ Menshawi, K; Mohr, JP; Gutierrez, J (May 2015). "A Functional Perspective on the Embryology and Anatomy of the Cerebral Blood Supply". Journal of Stroke. 17 (2): 144–58. doi:10.5853/jos.2015.17.2.144. PMC 4460334. PMID 26060802.
  5. ^ Uchino, A; Nomiyama, K; Takase, Y; Kudo, S (September 2006). "Anterior cerebral artery variations detected by MR angiography". Neuroradiology. 48 (9): 647–52. PMID 16786350.
  6. ^ Ropper, A.; Samuels, M.; Klein, J. (2014). Adams and Victor's Principles of Neurology (10th ed.). McGraw-Hill. p. 798. ISBN 978-0071794794.
  7. ^ Longo, D; Fauci, A; Kasper, D; Hauser, S; Jameson, J; Loscalzo, J (2012). Harrison's Principles of Internal Medicine (18th ed.). New York: McGraw-Hill. p. 3286. ISBN 978-0071748896.
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