The pericallosal artery is the distal continuation of the anterior cerebral artery running in the pericallosal cistern along the superior surface of the corpus callosum, supplying the corpus callosum and the medial parietal and parieto-occipital cortex. Aneurysms at the ACA-callosomarginal bifurcation are called pericallosal aneurysms and are the most common distal ACA aneurysm site.
Pericallosal artery occlusion produces the anterior disconnection syndrome when the genu and body of the corpus callosum are infarcted: ideomotor apraxia of the left hand (commands from the left hemisphere cannot cross the midline), alien hand syndrome, and tactile anomia of the left hand. Pericallosal aneurysms are approached via the interhemispheric corridor with the patient positioned supine and the head extended, using a bifrontal or unilateral parasagittal craniotomy. The bridging veins to the superior sagittal sinus must be preserved during interhemispheric retraction.
Ruptured pericallosal artery aneurysm at the ACA bifurcation produces an interhemispheric haematoma with corpus callosum involvement, presenting with leg-predominant hemiparesis, mutism, and disconnection signs; CT shows blood in the interhemispheric fissure and callosal region, and CTA confirms the aneurysm location for interhemispheric clipping.
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