open access
A tale of two arteries: dual posterior cerebral arteries with vascular bridges. A possible protective pattern?
, 1
Affiliations- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, United States
- Department of Otolaryngology and Facial Plastic Surgery, Henry Ford Macomb, Clinton Twp, MI, United States
open access
Abstract
Stroke is a common morbidity and a frequent cause of disability and even death. The impact of cerebrovascular events is dictated by the brain region involved and can be complicated by anatomical variations. One of the most common variations impacting the cerebral vasculature is the presence of a foetal 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 (foetal PCA) and one from the basilar. The foetal 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 PCA were connected to each other by a vascular bridge and the foetal 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 PCA.
Abstract
Stroke is a common morbidity and a frequent cause of disability and even death. The impact of cerebrovascular events is dictated by the brain region involved and can be complicated by anatomical variations. One of the most common variations impacting the cerebral vasculature is the presence of a foetal 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 (foetal PCA) and one from the basilar. The foetal 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 PCA were connected to each other by a vascular bridge and the foetal 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 PCA.
Keywords
variation, cerebral, vasculature, foetal
About this articleTitle
A tale of two arteries: dual posterior cerebral arteries with vascular bridges. A possible protective pattern?
Journal
Issue
Article type
Case report
Pages
455-459
Published online
2020-07-08
Page views
1274
Article views/downloads
1255
DOI
Pubmed
Bibliographic record
Folia Morphol 2021;80(2):455-459.
Keywords
variation
cerebral
vasculature
foetal
Authors
Y. Mansour
R. Kulesza
References (11)- 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.
- 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.
- 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.
- 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.
- 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.
- Stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/index (2020, April 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.
- 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.
- 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.
- 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.
- 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.
