Aneurysms of the P2P Segment of Posterior Cerebral Artery: Case Report and Surgical Steps.

Paulo Aguiar,Luana Gatto,Gustavo Isolan,Maick Neves,Carlos Martins,Fabio Nakasone

doi:10.1155/2014/325414

Abstract

The posterior cerebral artery (PCA) is divided into 4 segments: precommunicating segment (P1), postcommunicating segment (P2), quadrigeminal segment (P3), and calcarine segment (P4). Small aneurysms are more prevalent than large aneurysms in patients with ruptured aneurysms. P2 and P3 aneurysms are usually managed by the subtemporal approach. This is a case report of rupture saccular aneurysm of posterior cerebral artery on P2P segment. The authors show the surgical steps of these rare aneurysms with an illustrative case.

Highlights

The posterior cerebral artery (PCA) is divided into four segments: P1, P2, P3, and P4
The P2 segment of the PCA has in its junction the origin of posterior communicating artery (PComA), with a mean length of 19.9 mm
The P2A begins at the PComA and its way between the peduncle and uncus; the P2P begins at the posterior edge of the cerebral peduncle at the junction of the crural and ambient cistern [1]

Summary

Introduction

The posterior cerebral artery (PCA) is divided into four segments: P1 (precommunicating segment), P2 (postcommunicating segment), P3 (quadrigeminal segment), and P4 (calcarine segment). The P2A begins at the PComA and its way between the peduncle and uncus; the P2P begins at the posterior edge of the cerebral peduncle at the junction of the crural and ambient cistern [1]. The branches of these segments are the peduncular perforating and thalamogeniculate arteries, branches to the ventricles and to the choroid plexus, besides inferior temporal branches (anterior, middle and posterior temporal arteries) [1]. Small aneurysms are more prevalent than large aneurysms in patients with ruptured aneurysms. The risk of hemorrhage associated with repair of unruptured intracranial aneurysms may depend on the size and location of aneurysm and the probability of aneurysm rupture is proportional to the cube of aneurysm diameter [2]

Case Report

Discussion