The circulation of the cerebral peduncle is mainly supplied by perforating branches from the collicular artery, posteromedial choroidal artery
, and circumflex branches from the pi or p2 segment of PCA.
They cover basic anatomy, external and internal carotid arteries, the carotid-ophthalmic triangle, posterior communicating artery and anterior choroidal artery
, middle cerebral artery, anterior cerebral and anterior communicating arteries, basilar bifurcation and posterior cerebral arteries, vertebral and basilar arteries, and venous anatomy.
Four were on the left side of the anterior circulation (Figures 1 and 2): one at the bifurcation of the left internal carotid artery (ICA) and anterior choroidal artery
(AN1), 2 adjacent ones in the horizontal part of the left middle cerebral artery (MCA) (AN2 and AN3), and one at the bifurcation of the left MCA (AN4).
Digital subtraction cerebral angiography (DSA) showed multiple vascular lesions, including an obvious saccular aneurysm on the left anterior choroidal artery
. After surgical clipping, rebleeding was noted, and repeat DSA demonstrated that the bleeding site was on the right posterior cerebral artery.
The presence of other infarction areas in the PCA territory (supplying the occipital and the mesial temporal lobe) or their branches (e.g., collicular artery, posteromedial choroidal artery
, penetrating midbrain arteries, etc.) could help to consider other mechanisms of stroke than lipohyalinosis or microatheroma.