Year : 2015  |  Volume : 2  |  Issue : 3  |  Page : 130-132

Can Internal Carotid Artery Occlusion Produce Simultaneous Anterior and Posterior Circulation Stroke?

Department of Neurology, PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu, India

Correspondence Address:
Prasanna Venkatesan Eswaradass
Department of Neurology, PSG Institute of Medical Science and Research, Coimbatore, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-0820.166934

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Collateral circulation in the brain is important for maintaining a sufficient cerebral blood flow in case of obstructive disease of arteries. In case of hemodynamic compromise to the anterior circulation, the posterior circulation supplies the anterior circulation via the collaterals. Simultaneous anterior and posterior circulation stroke is a very rare occurrence. It can occur due to cardioembolic stroke or due to anatomical variants of the circle of Willis. Fetal origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), persistent trigeminal artery, and persistent hypoglossal artery are known to present with posterior circulation stroke due to occlusive disease of ICA. Here we report a 85-year-old man who presented to us with left hemiparesis. On evaluation, he had right middle cerebral artery (MCA), anterior cerebral artery (ACA), and PCA infarct. Our case most likely had fetal PCA, which can readily explain the PCA infarction in ICA occlusion. Although cases of simultaneous MCA and PCA infarction had been reported in past, we report the first case with simultaneous ACA, MCA, and PCA infarction secondary to fetal PCA.

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