Perforating branches of the basilar bifurcation

Area of Science:

• Neurosurgery
• Neuroanatomy

Background:

• The basilar artery and posterior cerebral artery supply critical blood flow to the brainstem and cerebrum.
• Understanding the perforating branches of these arteries is crucial for neurosurgical interventions.
• Variations in these perforating arteries can impact surgical approaches and outcomes.

Purpose of the Study:

• To anatomically characterize the perforating branches originating from the upper basilar artery and the P1 segment of the posterior cerebral artery.
• To analyze the origin and course of these perforating arteries in fixed human cadaveric brains.

Main Methods:

• Dissection and morphological analysis of 50 fixed human cadaver brains.
• Detailed examination of the basilar artery bifurcation and the P1 segments of the posterior cerebral arteries.
• Documentation of the origin, course, and branching patterns of perforating arteries.

Main Results:

• No vertical branches were observed arising from the basilar artery bifurcation.
• Horizontal branches originated from the upper basilar artery, with their angles of origin analyzed.
• Perforating arteries were consistently found arising from the P1 segments of the posterior cerebral artery in all specimens.
• Rarely, branches originated from the inferior and anterior surfaces of the P1 segments.

Conclusions:

• The anatomical patterns of perforating branches from the upper basilar and P1 segments of the posterior cerebral artery are described.
• Preoperative knowledge of basilar apex anatomy, including the angle between P1 segments and relationships to surrounding structures, is vital.
• This anatomical understanding can aid in selecting optimal neurosurgical approaches for basilar apex aneurysms, potentially improving surgical results.