Microsurgical Anatomy and Surgical Relevance of the Internal Frontal Arteries: A Cadaveric Anatomic Study

Purpose: To investigate the microsurgical anatomy, morphologic variability, and morphometric features of the anterior (AIFA), middle (MIFA), and posterior (PIFA) internal frontal arteries. Methods: Seventeen formalin-fixed, latex-injected cadaveric heads (34 hemispheres) were examined using microsurgical techniques. Five hemispheres were excluded due to inadequate vascular filling or preservation, resulting in a final sample of 29 hemispheres. Results: The AIFA, MIFA, and PIFA were identified in 96.5%, 93.1%, and 96.5% of hemispheres, respectively. The most common origin of the AIFA and MIFA was the callosomarginal artery (41.4%), whereas the PIFA most frequently arose from the A4 segment (44.8%). Common trunks were observed between AIFA–MIFA (31%) and MIFA–PIFA (10.3%). Arterial duplications and bihemispheric variants were uncommon. Intrahemispheric anastomoses were identified in 24.1% (AIFA–MIFA), 10.3% (MIFA–PIFA), and 27.6% (PIFA–paracentral lobule artery) of hemispheres. Conclusion: The IFA branches show variability in origin, duplication, and interconnections. These features are directly relevant to interhemispheric surgical approaches, in which injury to the distal ACA branches may result in motor or cognitive deficits. Recognition of these patterns may improve surgical planning and reduce the risk of ischemic complications.