Microsurgical Anatomy Of Pterional Approach On A₁ Segment Of Anterior Cerebral Artery And Anterior Communieating Artery And Their Perforating Arteries

Objective To study the microanatomy of A₁ segment of anterior cerebral artery(ACA) and anterior communicating artery(AcoA) and their Perforating Arteries via pterional approach,to provide anatomical guide and data for neurosurgeons.Methods Microanatomy anatomy and measurement about A₁ segment of ACA and AcoA and their perforating arteries were performed in both side of 10 adult red-latex perfuse cadaver heads along with the path of the pterional approach under the surgical microscope.Result The pterional approach can provide excellent exposure of A₁ segment of anterior cerebral artery(ACA) and anterior communicating artery(AcoA) and their perforating arteries.The perforating arteries of A₁ 1.Heubner's recurrent artery,found 9 Heubner's recurrent arteries arose from A₁ segment out of 20 sides(42.9%),it is the biggest perforating branch of A₁ segment.We found only one case which had two Heubner's recurrent arteries arising from left A₁ segment,the others were single one in all specimens.Heubner' s_<sub>recurrent artery traveling at the top on the inside of A₁,entering basal ganglia,basal nuclei from the anterior perforated substance.2.Antero-perforate arteries,most of them arising from lateral 1/3 wall of A₁,the average number of 3.6,entering medial part or intermedius of the anterior perforated substance.3.Hypothalamus perforating arteries,most of them arising from medial part 1/3 wall of A₁, the average number of 3.2,traveling before the bottom or back below, be scattered at optic lemniscuses,superior part of optic chiasm and lamina terminals.The perforating arteries of AcoA:all of them arising from the posterior and inferior wall of A₁,without one branch on the anterior.The average number of 3.2,stop at the front of the hypothalamus,the dorsal aspect of optic chiasm and anterior perforated substance.Conclusions Familiar the microanatomy of A₁ segment of anterior cerebral artery(ACA) and anterior communicating artery(AcoA) and their perforating arteries,on the security expose operation areas via pterional approach and avoid damage of blood vessels is of great significance.