The artery of bernasconi and cassinari: A morphometric study for superselective catheterization

Abstract

BACKGROUND AND PURPOSE: The artery of Bernasconi and Cassinari is an important infraclinoid branch of the internal cerebral artery. It is of neuroendovascular relevance in view of its supply to complex lesions such as meningiomas and arteriovenous malformations in the tentorial and falcotentorial regions. The present microanatomic study attempts a morphometric elucidation of this slender but important branch of the meningohypophyseal trunk. MATERIALS AND METHODS: The origin, course, dimensions, and related variations of the tentorial artery were studied in 10 formalin-fixed human cadaveric sides. RESULTS: The tentorial artery originated from the meningohypophyseal trunk in all but 1 specimen, in which it arose directly from the intracavernous internal carotid artery. In 80% of specimens, it took origin as a single branch; as a bifurcation and trifurcation in 1 each. It was usually the terminal branch of the meningohypophyseal trunk (in 90%). In all, 5 distinct microvascular patterns were noted. The mean diameter of this artery was 0.7 mm (range, 0.3- 0.8 mm; SD, ±0.1 mm). The mean length was 15.4 mm (range, 9-23 mm; SD, ±4.4 mm). Its mean distance from the origin of the meningohypophyseal trunk was 1.7 mm (range, 1.3-2.3 mm; SD, ±0.4 mm). The mean distance from the free edge of the tentorium was 3.7 mm (range, 3-5 mm; SD, ±0.7 mm). CONCLUSIONS: The artery of Bernasconi and Cassinari is an important vascular conduit to myriad neoplasms and vascular malformations in the vicinity of the tentorium cerebelli. In this era of advanced microneurosurgical techniques and superselective endovascular interventions, morphometric knowledge of this artery is important for precise and safe management of these lesions.