open access

Ahead of Print
Case report
Published online: 2020-07-08
Submitted: 2020-06-19
Accepted: 2020-07-01
Get Citation

A tale of two arteries: dual posterior cerebral arteries with vascular bridges. A possible protective pattern?

Y. Mansour, R. Kulesza
DOI: 10.5603/FM.a2020.0070
·
Pubmed: 32644187

open access

Ahead of Print
CASE REPORTS
Published online: 2020-07-08
Submitted: 2020-06-19
Accepted: 2020-07-01

Abstract

Stroke is a common morbidity and a frequent cause of disability and even death. The impact of cerebrovascular events are dictated by the brain region involved and can be complicated by anatomical variations. One of the most common variations impacting the cerebrovasculature is the presence of a fetal posterior cerebral artery. This vessel arises from the internal carotid artery instead of the basilar artery and is often associated with more extensive injury in cerebrovascular events. Herein, we report the case of a 60-year-old male who had numerous arterial abnormalities, including a kink and a coil of the left internal carotid, two posterior communicating arteries on the right and two posterior cerebral arteries (PCA) on the left, one arising from the internal carotid (fetal PCA) and one from the basilar. The fetal PCA supplied the thalamus, splenium of the corpus callosum and primary visual cortex. The basilar PCA supplied the midbrain and parts of the occipital lobe. These PCAs were connected to each other by a vascular bridge and the fetal PCA was connected to the middle cerebral artery by an additional vascular bridge. This vascular pattern would appear to provide collateral support around blockages in the internal carotid and main stem middle and posterior cerebral arteries.

Abstract

Stroke is a common morbidity and a frequent cause of disability and even death. The impact of cerebrovascular events are dictated by the brain region involved and can be complicated by anatomical variations. One of the most common variations impacting the cerebrovasculature is the presence of a fetal posterior cerebral artery. This vessel arises from the internal carotid artery instead of the basilar artery and is often associated with more extensive injury in cerebrovascular events. Herein, we report the case of a 60-year-old male who had numerous arterial abnormalities, including a kink and a coil of the left internal carotid, two posterior communicating arteries on the right and two posterior cerebral arteries (PCA) on the left, one arising from the internal carotid (fetal PCA) and one from the basilar. The fetal PCA supplied the thalamus, splenium of the corpus callosum and primary visual cortex. The basilar PCA supplied the midbrain and parts of the occipital lobe. These PCAs were connected to each other by a vascular bridge and the fetal PCA was connected to the middle cerebral artery by an additional vascular bridge. This vascular pattern would appear to provide collateral support around blockages in the internal carotid and main stem middle and posterior cerebral arteries.

Get Citation

Keywords

variation, cerebral, vasculature, fetal

About this article
Title

A tale of two arteries: dual posterior cerebral arteries with vascular bridges. A possible protective pattern?

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2020-07-08

DOI

10.5603/FM.a2020.0070

Pubmed

32644187

Keywords

variation
cerebral
vasculature
fetal

Authors

Y. Mansour
R. Kulesza

References (11)
  1. Benson JC, Brinjikji W, Messina SA, et al. Cervical internal carotid artery tortuosity: A morphologic analysis of patients with acute ischemic stroke. Interv Neuroradiol. 2020; 26(2): 216–221.
  2. Brzegowy P, Polak J, Wnuk J, et al. Middle cerebral artery anatomical variations and aneurysms: a retrospective study based on computed tomography angiography findings. Folia Morphol. 2018; 77(3): 434–440.
  3. de Monyé C, Dippel DWJ, Siepman TAM, et al. Is a fetal origin of the posterior cerebral artery a risk factor for TIA or ischemic stroke? A study with 16-multidetector-row CT angiography. J Neurol. 2008; 255(2): 239–245.
  4. Griessenauer CJ, Yalcin B, Matusz P, et al. Analysis of the tortuosity of the internal carotid artery in the cavernous sinus. Childs Nerv Syst. 2015; 31(6): 941–944.
  5. Klimek-Piotrowska W, Kopeć M, Kochana M, et al. Configurations of the circle of Willis: a computed tomography angiography based study on a Polish population. Folia Morphol. 2013; 72(4): 293–299.
  6. Stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/index (2020, April 7).
  7. Uchino A, Saito N, Takahashi M, et al. Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla. Neuroradiology. 2016; 58(2): 141–146.
  8. Vasović L, Trandafilović M, Jovanović I, et al. An excess vessel in the posterior part of the human cerebral arterial circle (CAC): a case series. BMC Neurol. 2010; 10: 53.
  9. Yu J, Qu L, Xu B, et al. Current understanding of dolichoarteriopathies of the internal carotid artery: a review. Int J Med Sci. 2017; 14(8): 772–784.
  10. Zampakis P, Panagiotopoulos V, Petsas T, et al. Common and uncommon intracranial arterial anatomic variations in multi-detector computed tomography angiography (MDCTA). What radiologists should be aware of. Insights Imaging. 2015; 6(1): 33–42.
  11. Zurada A, Gielecki JS. A novel formula for the classification of blood vessels according to symmetry, asymmetry and hypoplasia. Folia Morphol. 2007; 66(4): 339–345.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl