Duplicated fetal posterior cerebral artery in a patient with a ruptured fetal posterior cerebral artery aneurysm: a cerebrovascular variant

Jonathan Fisher, Keannette Russell, Justin Mascitelli

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: The most common neurovascular variant is the fetal posterior cerebral artery (FPCA), in which the P1 branch is absent or hypoplastic, and the majority of P2 supply is derived from the anterior circulation. While there are reports of hyperplastic anterior choroidal arteries (AChA) with supply to the temporo-occipital and calcarine regions, no reports of a duplicated FPCA exist. Methods: This case report describes a patient with a ruptured right FPCA aneurysm. Digital subtraction angiogram (DSA) revealed an artery with origin distal to the FPCA associated with the aneurysm. This was not consistent with a typical AChA. The FPCA associated with the aneurysm had the typical origin, course, and supply of a FPCA. The distal FPCA had a similar course of a typical FPCA with significant supply to the typical PCA territory. The patient underwent successful clipping of the aneurysm, and the duplicated FPCA was identified during the craniotomy. Results: The features of this duplicate FPCA, which has not been previously described, are discussed in comparison to another variant, the hyperplastic, anomalous AChA. The artery described in this report does not fit the typical criteria of this AChA variant. Therefore, the authors outline this variant as a duplicated FPCA. Conclusion: Recognition of variant cerebrovascular anatomy is vital to neurosurgeons and interventional neuroradiology specialists. FPCA aneurysms require special management considerations and are often more challenging to treat. This report discusses a duplicated FPCA. To our knowledge, this is the first description of this variant. A duplicated FPCA carries important management considerations in the management of neurovascular pathology.

Original languageEnglish (US)
Pages (from-to)35-38
Number of pages4
JournalSurgical and Radiologic Anatomy
Volume45
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • Anatomic variant
  • Anterior choroidal artery
  • Cerebral aneurysm
  • Duplicated cerebral artery
  • Fetal posterior cerebral artery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Surgery
  • Anatomy
  • Pathology and Forensic Medicine

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