Anteromedial central arteries

The anteromedial central arteries arising from the anterior cerebral artery (ACA) constitute a sub-group of the broader anteromedial central arterial group. They are also known as the ACA perforators or the medial lenticulostriate arteries.

Origin and course

• They arise mainly from the A1 (pre-communicating) segment of the anterior cerebral artery, although origins from A2 and anatomical variations have been reported. They pass mainly through the anterior perforated substance, superiorly and posteriorly, to reach the deep structures of the anterior cerebral hemisphere.

Distribution

Their territories are variable and overlap with those of neighbouring perforators, but include the anterior hypothalamus, anterior part of the caudate nucleus, adjacent parts of the putamen and globus pallidus, anterior limb of the internal capsule, septal and basal forebrain regions.

Relationship to the recurrent artery of Heubner

The recurrent artery of Heubner is a prominent named perforating artery associated with the ACA, typically arising near the A1–A2 junction. It courses posteriorly towards the anterior perforated substance and supplies portions of the caudate nucleus, putamen, globus pallidus and anterior limb of the internal capsule.

Compared with the AComA perforators (anteromedial central arteries of anterior communicating artery), which predominantly supply midline hypothalamic and commissural structures, the ACA anteromedial central arteries generally extend farther laterally into the basal ganglia and internal capsule.

Clinical correlate

Occlusion or injury to the anteromedial central arteries during surgery may produce infarction of the deep cerebral structures.

Relationship and distinction

Thus, the term anteromedial central arteries can be understood as a broader regional grouping of perforating arteries arising from the ACA–AComA complex. Some arise from the AComA and predominantly supply midline structures such as the lamina terminalis, hypothalamus, corpus callosum and anterior commissure, whereas others arise predominantly from A1 of the ACA and extend more extensively into the basal ganglia and internal capsule.