Posterior cerebral artery (PCA)-accessory PCA (hyperplastic anterior choroidal artery) anastomosis detected on...

Area of Science:

• Neurology
• Radiology
• Vascular Anatomy

Background:

• Cerebral infarction evaluation necessitates detailed neurovascular imaging.
• Anatomical variations in the circle of Willis can impact cerebral blood flow and stroke risk.

Observation:

• A 76-year-old male patient presented with a history of cerebral infarction.
• Cranial magnetic resonance (MR) imaging and angiography were performed on a 3-Tesla scanner.

Findings:

• A duplicated right posterior cerebral artery (PCA) was identified.
• The accessory PCA, arising from the internal carotid artery, supplied the parieto-occipital and calcarine territories.
• A small anastomotic channel between the accessory PCA and the typical PCA (originating from the basilar artery) was visualized.
• Three stenotic lesions were noted in the proximal accessory PCA.
• Findings were confirmed with computed tomography angiography.

Implications:

• This case demonstrates a rare variant of the posterior cerebral artery originating from the internal carotid artery.
• Partial maximum intensity projection (MIP) imaging on MR angiography is effective for diagnosing small arterial variations.
• Understanding such anatomical variations is crucial for accurate diagnosis and treatment planning in cerebrovascular diseases.