Purpose: The anatomy of the anterior communicating artery complex plays a critical role in surgical treatment of anterior cerebral circulation aneurysms. A thorough description of vascular variations of the anterior communicating artery complex seems to be lacking. The aim of this study was to describe the anatomical variations of the anterior communicating artery complex.
Methods: The study group consisted of 411 subjects (52.31% women), without any intracranial pathologies, that had undergone head computed tomography angiography. We used maximum intensity projections, volume rendering and multi planar reconstructions to study and classify the anatomical variations of the anterior communicating and anterior cerebral arteries.
Results: Male subjects had a significantly higher prevalence of the typical anterior communicating artery complex (59.69 vs. 46.05%; p < 0.01). The aplastic anterior communicating artery (23.26 vs. 15.88%; p = 0.04) and triple A2 segment of the anterior cerebral artery (1.86 vs. 0.00%; p = 0.05) were more common in women than in men.
Conclusion: Female subjects have a higher incidence of variations in the anterior communicating artery complex. There is a higher incidence of anterior communicating artery aplasia among women.