Accessory posterior cerebral artery (PCA): a rare variant of PCA

Accessory posterior cerebral artery

Article information

J Neurocrit Care. 2024; Epub ahead of print.

Publication date (electronic) : 2024 March 19

doi : https://doi.org/10.18700/jnc.240002

Youngchan Jung, MD ¹

, Sang Won Han, MD ¹

, Hyun-jeung Yu, MD, PhD^,²

¹Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

²Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, Korea

Corresponding author: Hyun-jeung Yu, MD, PhD Department of Neurology, Bundang Jesaeng General Hospital, 20 Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam13590, Korea Tel: +82-31-779-0216; Fax: +82-31-779-0897; E-mail: yhj314@dmc.or.kr

Received 2024 January 16; Accepted 2024 February 01.

In addition to hypoplasia or aplasia of the P1 segment of the posterior cerebral artery (PCA), rare variations of PCA include fenestration, early bifurcation, duplication of PCA, and hyperplastic anterior choroidal artery (AchA). One study found the prevalence of PCA fenestration, early bifurcation, duplication, and hyperplastic AChA to be 0.34%, 0.34%, 0.05%, and 0.55%, respectively [1]. Hyperplastic AchA, accessory PCA, and replaced PCA refer to the same variation, which depends on the part of the PCA territory that they supply [1-3]. Accessory PCA describes hyperplastic AchA that supplies a part of the PCA territory, and replaced PCA refers to hyperplastic AchA that supplies to all branches [1].

The three-dimensional study of the circle of Willis in 28-year-old woman with migraine revealed that both PCAs and superior cerebellar arteries originated normally from the basilar artery (Fig. 1). The right AchA was hyperplastic and covered areas of the parieto-occipital and calcarine branches. The left AchA was not visualized. In contrast to left side, there was no right posterior communicating artery. Our patient had an accessory PCA that supplied a portion of the PCA territory. It is essential to understand the anatomic variants of cerebral arteries when planning surgical or endovascular treatment.

Fig. 1.

Three-dimensional volume rendering view of the circle of Willis obtained using computed tomography angiography (CTA). Brain CTA showing the presence of the right posterior cerebral artery (arrowheads) and hyperplastic right anterior choroidal artery (AchA; arrows). The right AchA supplies the areas of the parieto-occipital and calcarine branches. Unlike the left side (asterisk), there was no posterior communicating artery at the right.

Notes

Ethics statement

This study was approved by the Clinical Trial Review Committee of Sanggye Paik Hospital (No. SGPAIK 2023-03-011), and written informed consent was obtained from the patient.

Conflict of interest

No potential conflict of interest relevant to this article.

Author contributions

Conceptualization: all authors. Data curation: all authors. Supervision: HJY. Validation: SWH, HJY. Visualization: JY. Writing–original draft: JY, SWH; Writing–review & editing: all authors.

References

1. Uchino A, Saito N, Takahashi M, Okano N, Tanisaka M. Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla. Neuroradiology 2016;58:141–6.

2. Takahashi S, Suga T, Kawata Y, Sakamoto K. Anterior choroidal artery: angiographic analysis of variations and anomalies. AJNR Am J Neuroradiol 1990;11:719–29.

3. Rusu MC, Vrapciu AD, Lazăr M. A rare variant of accessory posterior cerebral artery. Surg Radiol Anat 2023;45:523–6.

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