J Korean Neurosurg Soc.  2015 May;57(5):350-358. 10.3340/jkns.2015.57.5.350.

Morphometric Study of the Anterior Thalamoperforating Arteries

• Kim SH
• Yeo DK
• Shim JJ
• Yoon SM
• Chang JC
• Bae HG

• KMID: 1881732
• DOI: http://doi.org/10.3340/jkns.2015.57.5.350

Abstract

OBJECTIVE
To evaluate the morphometry of the anterior thalamoperforating arteries (ATPA).
METHODS
A microanatomical study was performed in 79 specimens from 42 formalin-fixed adult cadaver brains. The origins of the ATPAs were divided into anterior, middle, and posterior segments according to the crowding pattern. The morphometry of the ATPAs, including the premammillary artery (PMA), were examined under a surgical microscope.
RESULTS
The anterior and middle segments of the ATPAs arose at mean intervals of 1.75+/-1.62 mm and 5.86+/-2.05 mm from the internal carotid artery (ICA), and the interval between these segments was a mean of 3.17+/-1.64 mm. The posterior segment arose at a mean interval of 2.43+/-1.46 mm from the posterior cerebral artery (PCA), and the interval between the middle and posterior segments was a mean of 3.45+/-1.39 mm. The mean numbers of perforators were 2.66+/-1.19, 3.03+/-1.84, and 1.67+/-0.98 in the anterior, middle, and posterior segments, respectively. The PMA originated from the middle segment in 66% of cases. A perforator-free zone was located >2 mm from the ICA in 30.4% and >2 mm from the PCA in 67.1% of cases.
CONCLUSION
Most perforators arose from the anterior and middle segments, within the anterior two-thirds of the posterior communicating artery (PCoA). The safest perforator-free zone was located closest to the PCA. These anatomical findings may be helpful to verify safety when treating lesions around the PCoA and in the interpeduncular fossa.

Keyword

Anterior thalamoperforating artery; Premammillary artery; Perforator-free zone

MeSH Terms

Adult
Arteries*
Brain
Cadaver
Carotid Artery, Internal
Crowding
Humans
Passive Cutaneous Anaphylaxis
Posterior Cerebral Artery

Figure

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  Fig. 1 Photographs showing the posterior communicating artery, perforators and relative anatomical structures on infero-superior view of cadaveric specimen. A : optic chiasm, B : internal carotid artery, C : posterior communicating artery, D : optic tract, E : anterior thalamoperforating arteries, F : cerebral peduncle, G : P2 segment of posterior cerebral artery, H : P1 segment of posterior cerebral artery, I : mammillary body, J : tuber cinereum, K : anterior choroidal artery.

• 

  Fig. 2 Phtographs showing the variants of the posterior communicating artery (PCoA) and premammillary artery (PMA). A : The PMA (black arrow) is formed by an anastomosis of a perforator from the posterior cerebral artery (PCA) (black star) and a perforator from the posterior segment of the PCoA (black arrowhead). B : A specimen showing a double PMA (black arrowheads) and an anastomosis (black star) between perforators from the middle segment of PCoA (black arrows). C : A specimen showing absence of PCoA (white circle) on infero-superior view. D : A specimen showing a common origin of the anterior choroidal artery (AchoA) and the PCoA indicated by the black star. Enlarged view of the common origin of the AchoA and PCoA is shown in the inner box. BA : basilar artery, I : infundibulum, ICA : internal carotid artery, MB : mammillary body, OC : optic chiasm, SCA : superior cerebellar artery, TC : tuber cinereum.

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  Fig. 3 Photograph showing the paramedian perforating substance on infero-superior view of cadaveric specimen. Premammillary artery (black arrowhead) and anterior thalamoperforating arteries penetrate the paramedian perforating substance which is surrounded by the mammillary bodies, optic tract, and the cerebral peduncle, indicated by the white triangle. A : optic tract, B : posterior communicating artery, C : internal carotid artery, D : cerebral peduncle, E : posterior cerebral artery, F : mammillary body.

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  Fig. 4 Schematic view and cadaveric specimen showing the segments of posterior communicating artery (PCoA) according to the crowding pattern of anterior thalamoperforating arteries. Black arrows mean the length of each segment occupying the PCoA. Red arrows indicate the interval between each segment. Red circles indicate the perforator-free zone from the internal carotid (ICA) and the posterior cerebral arteries (PCA), respectively. Fine single perforator arising from the posterior segment of PCoA is visible. Both anterior and middle segments roughly occupied the anterior two-thirds of the PCoA. Ant : anterior segment, Mid : middle segment, Post : posterior segment.

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  Fig. 5 Photographs showing the anastomoses between perforators. A : Anastomosis between premammillary artery (black arrowhead) and a perforator from the posterior segment of posterior communicating artery (PCoA) (black arrow). B : Anastomsis between the perforator from the posterior segment of PCoA (black arrowhead) and a perforator from the PCA (black arrows). Black star indicates the anastomosis site. Each segment of PCoA is indicated. ICA : internal carotid artery, PCA : posterior cerebral artery.

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  Fig. 6 Cadaveric specimen showing the origin surface of premammillary artery (PMA) (black arrowhead) arising from posterior communicating artery (PCoA). A : PMA originates from the superolateral surface of the right PCoA. B : PMA originates from the lateral surface of the left PCoA. C : PMA originates from the medial surface of the right PCoA, ICA : internal carotid artery.

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  Fig. 7 Cadaveric specimens showing the reduction of diameter of the posterior communicating artery (PCoA) after the emergence of the premammillary artery (PMA). Arrowhead indicates PMA, blackstar indicates the reduction of diameter of the PCoA, and black arrow indicates single fine perforator arising from posterior segment of PCoA. ICA : internal carotid artery, PCA : posterior cerebral artery.

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