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Stroke Research and Treatment
Volume 2013 (2013), Article ID 105937, 6 pages
http://dx.doi.org/10.1155/2013/105937
Clinical Study

Circle of Willis Variants: Fetal PCA

1Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
2Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, RWUH M226, 619 19th Street S, Birmingham, AL 35249-3280, USA
3Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, RWUH M226, 619 19th Street S, Birmingham, AL 35249-3280, USA
4Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
5Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Received 14 November 2012; Revised 16 January 2013; Accepted 16 January 2013

Academic Editor: David S. Liebeskind

Copyright © 2013 Amir Shaban et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We sought to determine the prevalence of fetal posterior cerebral artery (fPCA) and if fPCA was associated with specific stroke etiology and vessel territory affected. This paper is a retrospective review of prospectively identified patients with acute ischemic stroke from July 2008 to December 2010. We defined complete fPCA as absence of a P1 segment linking the basilar with the PCA and partial fPCA as small segment linking the basilar with the PCA. Patients without intracranial vascular imaging were excluded. We compared patients with complete fPCA, partial fPCA, and without fPCA in terms of demographics, stroke severity, distribution, and etiology and factored in whether the stroke was ipsilateral to the fPCA. Of the 536 included patients, 9.5% ( ) had complete fPCA and 15.1% ( ) had partial fPCA. Patients with complete fPCA were older and more often female than partial fPCA and no fPCA patients, and significant variation in TOAST classification was detected across groups ( ). Patients with complete fPCA had less small vessel and more large vessel strokes than patients with no fPCA and partial fPCA. Fetal PCA may predispose to stroke mechanism, but is not associated with vascular distribution, stroke severity, or early outcome.