{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:03:34Z","timestamp":1789776214809,"version":"4.0.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"20","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,13]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>A bilateral infraoptic origin of the anterior cerebral arteries (ACAs) is a rare anatomical variant that can be encountered during anterior skull base surgery. The ACAs arise from the internal carotid artery (ICA) at the level of the ophthalmic artery and course medially, traveling inferior to the ipsilateral optic nerves. Herein, the authors discuss the different configurations of the anatomical variant, its prevalence, and hypotheses leading to the variable configuration of this anomaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 67-year-old woman presented with worsening dizziness over a week-long period and was found to have a large left sphenocavernous meningioma with optic, cavernous, and suprasellar extension. The tumor incorporated the left supraclinoid ICA and its branches. She underwent a left modified orbitozygomatic craniotomy for tumor resection. Early identification of the aberrant ACA anatomy was crucial in avoiding vascular injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>While this variant is typically encountered during the treatment of vascular pathologies\u2014namely, intracranial aneurysms\u2014its existence should be kept in mind during the treatment of any anterior skull base pathology. Failure to account for the presence of this variant may lead to potential intraoperative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23418","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T18:54:04Z","timestamp":1699901644000},"source":"Crossref","is-referenced-by-count":4,"title":["Bilateral infraoptic origin of the anterior cerebral artery: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Neil","family":"Majmundar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hackensack Meridian Health\u2013Jersey Shore University Medical Center, Neptune, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Quillin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Texas Health Plano, Plano, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James K","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, New Jersey Medical School, Rutgers University, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj K","family":"Agarwalla","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, New Jersey Medical School, Rutgers University, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Anat","first-page":"131","article-title":"An unusual human anterior cerebral artery","volume":"93","author":"Robinson LR","year":"1959","unstructured":"Robinson LR. An unusual human anterior cerebral artery. J Anat. 1959;93(1):131\u2013133."},{"key":"b2","series-title":"Diagnostic Cerebral Angiography","author":"Osborn AG","year":"1999","unstructured":"Osborn AG, Jacobs JM, Osborn AG. Diagnostic Cerebral Angiography. 2nd ed. Lippincott-Raven; 1999."},{"issue":"8","key":"b3","series-title":"Surg Radiol Anat","first-page":"937","article-title":"Infraoptic anterior cerebral artery (ACA) versus carotid-ACA anastomosis","volume":"39","author":"Uchino A","year":"2017","unstructured":"Uchino A. Infraoptic anterior cerebral artery (ACA) versus carotid-ACA anastomosis. Surg Radiol Anat. 2017;39(8):937."},{"key":"b4","series-title":"Clin Imaging","first-page":"8","article-title":"Infraoptic anterior cerebral artery or carotid-anterior cerebral artery anastomosis: a very rare embryological variation. Case series and review of literature","volume":"79","author":"Kochar PS","year":"2021","unstructured":"Kochar PS, Soin P, Elfatairy K. Infraoptic anterior cerebral artery or carotid-anterior cerebral artery anastomosis: a very rare embryological variation. Case series and review of literature. Clin Imaging. 2021;79:8\u201311."},{"issue":"1","key":"b5","series-title":"NMC Case Rep J","first-page":"465","article-title":"A ruptured anterior communicating artery aneurysm with infra-optic course of the anterior cerebral artery: a case report and a short review","volume":"8","author":"Tanaka K","year":"2021","unstructured":"Tanaka K, Ishida F, Tanioka S, Suzuki H. A ruptured anterior communicating artery aneurysm with infra-optic course of the anterior cerebral artery: a case report and a short review. NMC Case Rep J. 2021;8(1):465\u2013472."},{"issue":"6","key":"b6","series-title":"Neurosurgery","first-page":"1315","article-title":"Infraoptic course of the anterior cerebral artery associated with an anterior communicating artery aneurysm: anatomic case report and embryological considerations","volume":"44","author":"Spinnato S","year":"1999","unstructured":"Spinnato S, Pasqualin A, Chioffi F, Da Pian R. Infraoptic course of the anterior cerebral artery associated with an anterior communicating artery aneurysm: anatomic case report and embryological considerations. Neurosurgery. 1999;44(6):1315\u20131319."},{"issue":"10","key":"b7","series-title":"Acta Neurochir (Wien)","first-page":"1087","article-title":"Infraoptic anterior cerebral artery: review, report of two cases and an anatomical classification","volume":"150","author":"Wong ST","year":"2008","unstructured":"Wong ST, Yuen SC, Fok KF, Yam KY, Fong D. Infraoptic anterior cerebral artery: review, report of two cases and an anatomical classification. Acta Neurochir (Wien). 2008;150(10):1087\u20131096."},{"issue":"4","key":"b8","series-title":"Clin Neurol Neurosurg","first-page":"335","article-title":"Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review","volume":"113","author":"Turkoglu E","year":"2011","unstructured":"Turkoglu E, Arat A, Patel N, Kertmen H, Ba\u015fkaya MK. Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review. 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Surg Radiol Anat. 2022;44(5):737\u2013748."},{"issue":"2","key":"b11","series-title":"Surg Neurol","first-page":"97","article-title":"Infraoptic course of the anterior cerebral artery associated with a pituitary tumor","volume":"20","author":"Sheehy JP","year":"1983","unstructured":"Sheehy JP, Kendall BE, Thomas DG. Infraoptic course of the anterior cerebral artery associated with a pituitary tumor. Surg Neurol. 1983;20(2):97\u201399."},{"issue":"6","key":"b12","series-title":"J Neurosurg","first-page":"950","article-title":"Surgically verified variations in the A1 segment of the anterior cerebral artery. Report of two cases","volume":"75","author":"M\u00e4urer J","year":"1991","unstructured":"M\u00e4urer J, M\u00e4urer E, Perneczky A. Surgically verified variations in the A1 segment of the anterior cerebral artery. Report of two cases. 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Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review. Clin Neurol Neurosurg. 2011;113(4):335\u2013340."},{"issue":"1","key":"b9","series-title":"Neuroradiology","first-page":"13","article-title":"Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study","volume":"54","author":"Uchino A","year":"2012","unstructured":"Uchino A, Saito N, Okada Y, Inoue K. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study. Neuroradiology. 2012;54(1):13\u201318."},{"issue":"5","key":"b10","series-title":"Surg Radiol Anat","first-page":"737","article-title":"Embryology of the anterior communicating artery complex: implications on possible adult variants","volume":"44","author":"Bonasia S","year":"2022","unstructured":"Bonasia S, Smajda S, Ciccio G, Bojanowski MW, Robert T. 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