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# Anterior communicating artery

The anterior communicating artery is a short link joining the two anterior cerebral arteries; it is the most common site of brain aneurysms.

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## What it is

A very short bridge joining the two anterior cerebral arteries.

## What it does

Closes the front of the [circle of Willis](https://durgical.com/en/anatomy/cerebral-arterial-circle/); the most common site of brain aneurysms.

## Key points

- A ruptured aneurysm here bleeds into the interhemispheric fissure and the gyrus rectus; blood in those places on CT points to this site
- After rupture or repair, damage to its small perforators to the basal forebrain can cause memory loss, confabulation and personality change
- Aneurysms here are more common when one A1 segment is small, because the flow for both sides then crosses the bridge

## Key facts

**Origin**
Joins the two anterior cerebral arteries

**Branches**
Small perforators

**Supplies**
Closes the front of the circle of Willis; most common aneurysm site

## Relations

**Course**
A short bridge across the midline in front of the [optic chiasm](https://durgical.com/en/anatomy/optic-chiasm/), joining the two anterior cerebral arteries where their A1 and A2 segments meet

**Below**
Optic chiasm

**Behind**
Lamina terminalis and the front of the [hypothalamus](https://durgical.com/en/anatomy/hypothalamus/)

**Above**
Gyrus rectus and the medial orbital surface of the frontal lobes

## How to find it

It cannot be felt. It lies just above the optic chiasm, in front of the lamina terminalis, joining the two A1 segments; in a pterional craniotomy it is reached by following the internal carotid and A1 across the chiasm, often after removing a little of the gyrus rectus.

## On imaging

CT angiography finds most aneurysms here; catheter angiography, with angled views that open up the junction, plans treatment.

## Common problems

- Brain aneurysm: a weak bulge in the artery wall, most often at this junction.
- Rupture causes a subarachnoid haemorrhage: a sudden 'worst headache of my life'.

## How it is diagnosed

CT and CT angiography; angiography with a catheter to plan treatment; unruptured aneurysms are often found by chance on scans.

## Treatment

- Clipping: a small metal clip across the neck of the aneurysm through a craniotomy.
- Coiling: soft platinum coils packed inside it through a catheter from the groin or wrist.
- Watching some small unruptured aneurysms, with blood pressure control and no smoking.

## Clinical notes

- Ruptured aneurysms are secured by endovascular coiling or surgical clipping, chosen by the shape and position of the aneurysm
- A large aneurysm can press on the optic chiasm or [optic nerve](https://durgical.com/en/anatomy/optic-nerve/) and cause visual field loss
- Days after the bleed, vasospasm can narrow both anterior cerebral arteries

## Anatomical variants

- It may be duplicated, fenestrated or missing, with the two anterior cerebral arteries fused at that point

## Related conditions

- [Subarachnoid haemorrhage](https://durgical.com/en/conditions/subarachnoid-haemorrhage/)

## Test yourself

Think of the answer, then tap the question to see it.

## What is the most common site of berry aneurysms in the circle of Willis?

The anterior communicating artery, which joins the two anterior cerebral arteries.

## Where does a ruptured anterior communicating artery aneurysm bleed on CT?

Into the interhemispheric fissure and the gyrus rectus.

## What can damage to the perforators of the anterior communicating artery cause?

Memory loss, confabulation and personality change, from injury to the basal forebrain.

## How are ruptured anterior communicating artery aneurysms secured?

By endovascular coiling or surgical clipping, chosen by the shape and position of the aneurysm.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
arteria communicans anterior TA2 4517

**Official Spanish (DeCS)**
Arteria comunicante anterior

**English (TA2)**
Anterior communicating artery

## Related

- [Anterior cerebral artery](https://durgical.com/en/anatomy/anterior-cerebral-artery/)

Sources: Terminologia Anatomica (TA2); [Neuroanatomy, Circle of Willis](https://www.ncbi.nlm.nih.gov/books/NBK534861/).

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