Anomalous Origin of the Anterior Choroidal Artery Proximal to an Ipsilateral Fetal Posterior Cerebral Artery: Case Report of an Extremely Rare Anatomic Variant and Discussion of its Clinical Implications

Abstract

The anterior choroidal artery (AChA) supplies important cerebral structures such as the internal capsule, optic tract, and lateral geniculate body. It is normally a branch of the communicating segment of the internal carotid artery (ICA) with significant neurological symptomatology if injured. Typically, the AChA originates distal to the posterior communicating artery (PCoA), but rare variants have previously been described. Such anatomical differences are particularly important entities, especially in the context of neuroendovascular procedures, as inadvertent damage to these arteries can have devastating consequences. In this case report, we present an unusual anatomical pattern of the right AChA arising proximal to an ipsilateral fetal PCA.

An anomalous hyperplastic anterior choroidal artery associated with an unruptured internal carotid–posterior communicating artery aneurysm

“…There are reports of unexpected embolic complications in the perfusion region following endovascular surgery of anomalous cerebral arteries [1] . Foetal-type PComA is observed in approximately 20%-30% of the population and has important implications on the vascular anatomy and cerebral perfusion [4] . Therefore, thorough knowledge about the development, and anatomy of anomalous arteries is important for safely performing endovascular procedures without causing any ischemic complications.…”

Common origin of the anterior choroidal artery and posterior communicating artery with a concomitant aneurysm at the internal carotid artery-posterior communicating artery junction: A case report

“…However, the common origin of the PcomA and AChA is the rarest among all AChA variants ( 4 , 11 ). In a large cadaveric study of AChA anatomy performed by Otomo ( 5 ), 3 of the 778 anterior choroidal arteries (0.4%) arose from the PComA.…”

“…Among all possible anomalies, the common origin of the AChA and PcomA (namely the AChA originating from the PcomA) is particularly rare ( 4 ). In the study by Otomo ( 5 ), the incidence of the AChA originating from the PcomA in cadavers was only 0.4%.…”