Background: The anatomical characteristics of the anterior ethmoidal artery (AEA) exhibit a high degree of variability, especially regarding its topography. Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the AEA. Results: Ultimately, a compilation of 38 studies meeting the predetermined criteria, and possessing comprehensive and pertinent data, were incorporated into the current meta-analysis. In the overall analysis, reports of the AEA being embedded within the skull base or at the level of the skull base producing a bony protrusion were found in 56.91% of cases (95% CI: 43.55–69.80%). The mean diameters of the AEA in the intraorbital and intracranial areas were 0.94 mm and 0.76 mm, respectively. Moreover, the artery coursed most commonly between the second and third lamellae, with a prevalence of 65.82% (95% CI: 55.39–75.56%). Conclusions: The AEA may be at a high risk of iatrogenic injury during various sinus and skull base surgeries, especially if the surgeon performing these procedures is unfamiliar with the vast number of variations this vessel may exhibit. The spatial relationship between this vessel and the skull base is especially variable, and understanding this variability goes hand in hand with intraoperative safety.

Background/Objectives: The anterior cerebral artery (ACA), as one of the terminal branches of the internal carotid artery, supplies the medial and superior portions of the frontal lobes as well as the anterior portions of the parietal lobes. The present meta-analysis aims to consolidate current knowledge regarding the anatomy and variations in the ACA, providing a comprehensive resource for physicians. Methods: To conduct this meta-analysis, we systematically searched prominent online medical databases, including PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar, to identify all studies that investigated the anatomy of the ACA. Results: The results of the present study were based on a total of 73 articles. In the aforementioned studies, a total of 24,015 patients were evaluated. The pooled mean total length of the A1 segment of the ACA, based on all evaluated cases, was 14.47 mm (SE = 0.28). The pooled mean total diameter of the A1 segment measured 2.00 mm on average (SE = 0.07). The overall pooled prevalence of the median ACA was 2.65% (95% CI: 1.57–3.99%). Conclusions: This systematic review and meta-analysis provide valuable insights into the anatomy and variations in the ACA. The current data may support clinicians and neurosurgeons in the management of cerebrovascular diseases and associated procedures, potentially enhancing procedural safety and therapeutic outcomes.