Anterior Cerebral Artery: Variant Anatomy and Pathology

The anterior cerebral artery (ACA) contains anatomical variants that are closely related to its embryology
and development. In this study, the authors reviewed the most commonly encountered variants of the ACA
and anterior communicating artery. They also reviewed the embryological origins of these variants as well
as a variety of associated pathologies. Several variants are described and highlighted with illustrations
including: (1) the aberrant origin of the ACA from the internal carotid artery and its developmental associa‐
tion with the ophthalmic artery; (2) the persistent olfactory artery; (3) the azygous ACA; (4) the triplicated
ACA; and (5) multiple anterior communicating arteries. The formation of aneurysms is associated with
such variants, thus their knowledge and the embryology behind their development are crucial to prevent
injury to the patient.