Branching patterns and variations of the anterior choroidal artery: A detailed cadaveric morphometric analysis

The aim of our study was to investigate the morphometric and morphological characteristics of the anterior choroidal artery (AChA) and its branches. Also, the branching patterns and cortical termination sites of the AChA were examined by detailed morphometric analysis. For this purpose, 62 fresh cadavers (124 hemispheres) were included in the study. AChA diameter, length, and distances of branches to the AChA origin were measured using ImageJ software. The distribution of the branches according to arterial origin and their distances to the target regions was quantitatively defined. Although a total of 594 branches originating from AchA were observed, only 587 of these branches reached or terminated in the regions observed. Accordingly, 220/587 were found to go to the optic tract, 214/587 to the cerebral peduncle, 130/587 to the uncus, and 23/587 to the anterior perforated substance. Our study provides novel morphometric ratios that map the branching architecture of the AChA, confirming that branches originate predominantly from its midpoint (overall ratio:0.45). We found that 73.07% of AChA branches supply the optic tract and cerebral peduncle, highlighting their central role, while a minimal proportion (3.87%) serve the anterior perforated substance. These data elucidate the topo graphical relationships that are crucial for understanding pathologies like Moyamoya disease and proximal aneurysms. The established ratios offer invaluable benchmarks for anatomical navigation, potentially reducing risks in neurosurgical procedures involving the AChA territory.