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Middle Cerebral Artery Occlusion Allowing Reperfusion via Common Carotid Artery Repair in Mice

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Published on: January 23, 2019

Replaced posterior cerebral artery.

Hideki Endo¹, Kohei Ishikawa², Hidetoshi Ono³

¹Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-Ku, Sapporo, Hokkaido, 060-8570, Japan. endo@med.nmh.or.jp.

Surgical and Radiologic Anatomy : SRA

|February 5, 2024

Summary

A rare anatomical variation, the replaced posterior cerebral artery (PCA), was identified. This condition, where the anterior choroidal artery (AChA) supplies the PCA territory, was diagnosed via angiography.

Keywords:

Anatomical variation Anterior choroidal artery Hyperplastic anterior choroidal artery Persistent primitive anterior choroidal artery Posterior cerebral artery Replaced posterior cerebral artery

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Area of Science:

Neuroanatomy
Vascular Neurology
Radiology

Background:

The replaced posterior cerebral artery (PCA) is an extremely rare anatomical variation.
It is defined by a hyperplastic anterior choroidal artery (AChA) that supplies the entire territory of the PCA.

Observation:

A case of replaced PCA was diagnosed in a 76-year-old woman presenting with headache and vertigo.
Incidental findings during neuroimaging for a left internal carotid artery aneurysm revealed an anomalous, hyperplastic AChA.
This hyperplastic AChA supplied both the typical AChA territory and the entire PCA territory.

Findings:

Digital subtraction angiography confirmed the diagnosis of replaced PCA.
Key findings included the absence of a normal AChA and posterior communicating artery originating from the internal carotid artery.
The left PCA was not visualized on vertebral angiography.

Implications:

Accurate diagnosis of replaced PCA relies on careful imaging assessment.
Direct visualization of a hyperplastic AChA and its perfusion territory, along with indirect evidence of the absent normal PCA, are crucial for diagnosis.
Recognition of this variation is important for neurovascular procedures and understanding cerebrovascular anatomy.