Concurrent infarctions in the territories of internal carotid artery and posterior cerebral artery in the background of foetal type variant of posterior cerebral artery

A 46-year-old woman admitted with a headache and syncopal episode to the hospital, was found to have an upper-motor-neuron type weakness on the left side of the body on waking up the following day. Simultaneous right-sided infarctions of middle and posterior cerebral artery (MCA and PCA) territories were seen in magnetic-resonance-imaging (MRI) of the brain along with a left-sided foetal-posterior-cerebral-artery (fPCA). The concurrent PCA and MCA infarctions could be postulated due to, either a left-sided fPCA supplying the contralateral cerebrum or an invisible thrombosed right-sided fPCA supplying the ipsilateral cerebrum. This emphasises the importance of identifying the relationship between fPCA and the risk of large territorial stroke.