• Ioannis N Mavridis, Theodosis Kalamatianos, Christos Koutsarnakis, and George Stranjalis.
• Microneurosurgery Laboratory, Department of Neurosurgery, University of Athens School of Medicine, Evangelismos Hospital, Athens, Greece.
• Neurosurgery. 2015 Oct 27.

BackgroundThe ambiguous term precuneal artery (PA) has several synonyms and anatomic definitions.ObjectiveTo examine the arteries of the precuneus and describe the PA and its branching pattern. We defined the PA as the principal arterial supplier of the precuneus.MethodsTwenty formalin-fixed, colored latex-injected cadaveric heads were studied with the aid of an operating microscope and microsurgical instrumentation. After removal of the cerebrum from the cranial vault, we examined this vessel's anatomy. Anatomic features of the PA were investigated and assessed in relation to demographic and anthropometric variables.ResultsThe PA was always a pericallosal artery branch and, more specifically, the superior internal parietal artery (SIPA) in 86.84%, the inferior internal parietal artery in 2.63%, and their common stem in 10.53% of specimens. Anastomosing interhemispheric branches between the PAs were present in 20% of cases. Compared with the right PA, the left anastomosed nearly 3 times more often with the ipsilateral posterior cerebral artery. The average distance of the PA's origin from the posterior limit of the splenium was shown to be 9.4 mm longer in elderly individuals compared with younger ones.ConclusionThe term PA complex (rather than PA) can better describe the principal arterial supplier of the precuneus, and the SIPA, inferior internal parietal artery, and their common stem were shown as the 3 contributing arteries, with the SIPA predominating. The average distance of the PA complex origin from the splenium's posterior limit shows significant variation with respect to age.Abbreviationsa, anastomoses of precuneal branches with the contralateral hemisphere parameterACA, anterior cerebral arteryACoA, anterior communicating arteryARCS, ascending ramus of the cingulate sulcusb, precuneal branches anastomosing with the ipsilateral posterior cerebral artery parameter; posterior cerebral arteryBMI, body mass indexc, precuneal branches at the medial hemispheric surface parameterCC, corpus callosumd, length of the ascending ramus of the cingulate sulcus parametere, distance of the precuneal artery origin from the posterior limit of the corpus callosum parameterIIPA, inferior internal parietal arteryPA, precuneal arteryPCA, posterior cerebral arteryPcA, pericallosal arterySIPA, superior internal parietal artery.

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