Cadaveric and Radiological Evaluation of Artery of Percheron: A Cross-sectional Study

Introduction: The Artery of Percheron (AOP) is a thalamoperforating arterial trunk that provides blood supply to the paramedian thalami and the rostral midbrain. Occlusion of the AOP results in atypical ischaemia. Aim: To determine the morphology of the AOP and identify the type of AOP in cadaveric and radiological studies. Materials and Methods: The present cross-sectional study was conducted on 60 standard embalmed and formalinpreserved adult cadaveric brains obtained from the Department of Anatomy, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India from October 2023 to April 2024. The brain was dissected to identify the AOP, and its type was determined. Origin and course of the vessel were observed, and measurements were made from the point of its origin to its termination. In addition, the radiological study was done on 60 patients who were referred for Magnetic Resonance Angiography (MRA) to determine the circle of Willis, identify and categorise the type of AOP. Descriptive statistics were used to express categorical variables as frequencies and percentages continuous data was expressed as mean±standard deviation. Results: In the cadaveric study, out of 60 specimens, the AOP was seen in 21 specimens (35%), and the mean distance was 3.5±0.3 mm from the point of origin to its termination. Out of four types, Type I was observed in 12 cadavers (57.14%), Type IIA in 5 (23.81%), Type II B in 4 (19.04%), and Type III was not seen in any cadavers. However, in the radiological study, out of 60 cases, MRA imaging has shown the presence of the AOP in 14 patients (23.33%). Type I bilateral was observed in 9 (64.28%) and Type II B in 5 (35.71%), whereas Type IIA and Type III were not observed in any of the patients. Conclusion: Occlusion of the AOP results in a unique ischaemic pattern, typically affecting the bilateral paramedian thalami, with or without involvement of the midbrain. Because this condition is infrequently documented, cadaveric and radiologic studies are essential for increasing awareness and understanding of this anatomical variant.