Artery of Percheron, an Uncommon Variant of Posterior Cerebral Circulation: A Case Report

The posterior communicating artery (PcomA), P1 and P2 segments of the posterior cerebral arteries (PCAs) give rise to numerous small branches that chiefly supply the thalamus and midbrain. Thalamic vascular supply is classically categorized into four regions: anterior, paramedian, infero-lateral and posterior. Despite significant variations and overlap in the blood supply, this traditional classification helps in understanding the vascular anatomy of the thalamus. Gerard Percheron extensively studied thalamic blood supply and described its anatomical variants depending on its origin. The artery of Percheron (AOP) is a rare anatomical variation of paramedian-mesencephalic arterial supply in which a solitary arterial trunk arises from the PCA and distributes bilaterally to both paramedian thalami and often to the rostral part of the midbrain. During routine dissection of the brain of a 46-year-old female in the department of anatomy, it was seen that thalamo-perforating artery (AOP) took origin as a single trunk from the P1 segment of the left PCA. The specimen was dissected and photographed for documentation and to see more details. The exact prevalence of AOP remains unknown, but various studies show that it can be present in 7% to 11.7% of subjects. Detailed knowledge of AOP anatomical variation is crucial for interpreting neuroimaging results or performing different neuro-endovascular techniques at the basilar bifurcation, particularly in patients with bilateral thalamic and midbrain infarctions.