Anatomical variations of anterior cerebral artery and its cortical branches through 1.5 tesla magnetic resonance angiography

Background: Cortical branches of the anterior cerebral artery (ACA) supply the medial surface and superior border of the cerebral hemisphere. Names of distinct cortical branches are according to the regions of the brain supplied by that particular branch. There can be variations in the number, origin, and distribution of these branches. There can also be variations of the ACA like azygous, bi hemispheric, median, aplasia, and fenestration of the ACA. This study aimed to evaluate the anatomical variation of the ACA and its cortical branches taking into consideration their number and site of origin. Methodology: Retrospective cross-sectional analysis of magnetic resonance angigraphs of 80 subjects (42 males and 38 females) without cerebrovascular diseases who was undertaken in the department of radiodiagnosis from July 2021 to August 2022. Results: The cortical branches were seen either being completely absent or present singly or in duplication. The callosomarginal artery (CmA) branch was found to be most commonly absent (51.25% on the right side), paracentral lobule artery most commonly duplicated (10% of cases on the right). CmA gave origin to the maximum number of cortical branches as compared to other cortical branches. The abnormal origin of anterior cortical branches was found to be more than posterior cortical branches. A few rare cases of variations (1.25% cases each) like azygous, bihemispheric, aplastic, and median ACA. Conclusion: In the present study different variations were observed in the cortical branches of ACA. These variations may also result in higher incidence of ischemic stroke in territory of ACA, involving the superior medial part of the parietal lobe and midline of the frontal lobe. Therefore, this study can be of clinical importance to neurosurgeons during cerebral surgeries.