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Vol. 13. Issue 4.
Pages 285-298 (January 2002)
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Vol. 13. Issue 4.
Pages 285-298 (January 2002)
Bases anatómicas y hemodinámicas del complejo de la arteria comunicante anterior
Anatomic and hemodinamic, study of the anterior communicating artery complex
F. González-Llanos*,1,
, J.M. Pascual**,1, J.M. Roda***,1
* Servicio de Neurocirugía Hospital Virgen de la Salud. Toledo
** Servicio de Neurocirugía Hospital de la Princesa. Madrid
*** Servicio de Neurocirugía Hospital La Paz. Madrid
1 Unidad de Investigación Cerebrovascular Hospital La Paz
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Resumen

El complejo de la arteria comunicante anterior constituye la localización más frecuente de aneurismas cerebrales y se caracteriza por su gran número de variantes anatómicas. La presencia de aneurismas de la arteria comunicante anterior se ha asociado a la existencia de una asimetría de este complejo. El objetivo de este trabajo ha sido estudiar anatómica y hemodinámicamente el complejo de la arteria comunicante anterior. Se han estudiado 20 cerebros de cadáver adulto mediante disección microquirúrgica así como 118 angiografías cerebrales de pacientes diagnosticados de hemorragia subaracnoidea aneurismática.

Uno de los hallazgos más relevantes del estudio microanatómico ha sido la observación de un elevado número de arterias perforantes con origen en el complejo de la arteria comunicante anterior. Se describe detalladamente el número, distribución y tamaño de cada uno de los vasos del complejo. Del análisis de las angiografías se destaca la asociación de aneurismas del complejo de la arteria comunicante anterior a la presencia de dominancia de flujo sanguíneo a través de una de las dos arterias cerebrales anteriores proximales.

Palabras clave:
Estudio anatómico
Arteria comunicante anterior
Aneurisma cerebral
Hemorragia subaracnoidea
Hemodinámica
Summary

Anterior communicating artery complex accounts for the most frequent site of cerebral aneurysms and it is characterized by its great anatomical variability. The development of aneurysms in this complex has been associated with the asymmetry of its afferent vessels.

An anatomical and hemodynamic study of the anterior communicating artery was performed. Twenty brain samples obtained from adult necropsies were studied by means of microsurgical dissection. Adittionally; 118 cerebral angiographies from patients with spontaneous subarachnoid hemorrhage were studied.

A high number of perforanting vessels originated at the anterior communicating artery complex was a relevant finding. The number, distribution and size of these vessels is reported accurately. Analysis of the angiographies showed the association between the existence of an anterior communicating artery aneurysm and the presence of a blood flow predominance through one of the two proximal anterior cerebral arterias.

Key words:
Anatomic study
Anterior communicating artery
Cerebral aneurysm
Subarachnoid hemorrhage
Hemodinamic

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