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Circle of Willis Variants: Fetal PCA
Amir Shaban1, Karen C Albright, Amelia K Boehme
1Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA.
Stroke Research and Treatment
|April 12, 2013
Summary
Fetal posterior cerebral artery (fPCA) occurs in about 25% of stroke patients. Complete fPCA is linked to older females and different stroke causes, suggesting a potential predisposition to certain stroke mechanisms.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroimaging
Background:
- The fetal posterior cerebral artery (fPCA) is a variation in cerebral vasculature.
- Understanding its prevalence and association with stroke is crucial for clinical diagnosis.
Purpose of the Study:
- To determine the prevalence of complete and partial fetal posterior cerebral artery (fPCA).
- To investigate the association between fPCA and stroke etiology, vessel territory, severity, and outcomes.
Main Methods:
- Retrospective review of prospectively identified acute ischemic stroke patients (July 2008-December 2010).
- Intracranial vascular imaging was used to define complete fPCA (absent P1 segment) and partial fPCA (small P1 segment).
- Comparison of demographics, stroke severity, distribution, and etiology across fPCA groups (complete, partial, none).
Main Results:
- Prevalence: 9.5% complete fPCA (n=51), 15.1% partial fPCA (n=81) among 536 patients.
- Complete fPCA associated with older age and female gender.
- Significant variation in TOAST classification (stroke etiology) across groups (P=0.023).
- Complete fPCA linked to fewer small vessel and more large vessel strokes compared to no fPCA and partial fPCA.
Conclusions:
- Fetal PCA may predispose individuals to specific stroke mechanisms.
- fPCA is not associated with stroke vascular distribution, severity, or early outcomes.
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