Medicine & USMLE

Anterior Cerebral Artery (ACA)

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Strokes
  1. Anterior Cerebral Artery (ACA)
  2. Middle Cerebral Artery (MCA)
  3. Posterior Cerebral Artery (PCA)
  4. Lenticulostriate Artery
  5. Anterior Inferior Cerebellar Artery (AICA)
  6. Posterior Inferior Cerebellar Artery (PICA)
  7. Anterior Spinal Artery (ASA)
  8. Basilar Artery

Summary

The anterior cerebral artery or ACA is a blood vessel that supplies blood to the midline portions of the frontal and parietal lobes of the cerebral cortex. ACA strokes affect both the motor and sensory cortices of the brain near the midline. As a result, patients present with contralateral lower limb weakness and contralateral loss of sensation in the lower limb. Damage to the frontal micturition center can also lead to urinary incontinence.

Key Points

  • Anterior Cerebral Artery (ACA)
    • Area of Lesion
      • Motor and sensory cortices
        • Supplies midline portions of the frontal and superior medial parietal lobes
        • Corresponds with lower homunculus (lower extremities)
      • Compression may be caused by subfalcine (cingulate) herniations
    • Presentation
      • Mixed weakness/paralysis and sensory loss
        • Contralateral lower limbs/extremity
        • Upper extremity and face mostly spared
      • Urinary incontinence
        • Due to involvement of the frontal micturition center
      • Transcortical motor aphasia may be seen