Morphological evaluation of the distal medial striate artery. A study with cadaveric material.

Abstract

SUMMARY:

Background: The distal medial striated artery (DMSA) is a small, constant branch that emerges from the base of the anterior cerebral artery (ACA) and is directed backwards to irrigate internal structures such as the nucleous of the base.

Objective:  This study proposes to evaluate the morphology of the DMSA, useful for clinical and surgical management that compromise this vascular structure.

Methods: The DMSA of 71 unclaimed male bodies, who underwent necropsy at the Institute of Legal Medicine and Forensic Sciences of Bucaramanga-Colombia, were evaluated using the perfusion technique of vascular structures with polyester resin. Results: The DMSA was presented in four cases (2.8%) duplicated and with agenesis in 2.1% of the hemispheres. Its origin was 43.9% of the post-communicating segment of the ACA (A2), 10.8% of the pre-communicating segment of the ACA (A1) and 44.6% of the ACA junction site with the anterior communicating artery (AComA). The diameter of the DMSA was 0.5 ± 0.2 mm and its total length was 20.3 ± 4.1 mm. Sinuous trajectory was observed in 73 cases (51.4%). There was a superolateral relationship with the ACA in 48% of the samples. The DMSA was observed in 129 cases (90.9%) as a single trunk while in 6 cases (4.2%) it presented with a common trunk with the orbitofrontal artery (OF). The completion of the DMSA in the anterior perforated substance was given by a single trunk in 129 cases (90.9%) bifurcation in 9 cases (6.3%) and trifurcation in four cases (2.8%). The incidence of sinuous presentation and hypoplasia of the DMSA is considerably higher than previously reported.

Conclussions: The importance of the DMSA lies in its involvement with the surgical procedures and interventions of the anterior segment of the arterial cerebral circle, and in the complex clinical management that determine its injury in clinical practice.