Normal Variants

It is important to have a strong fund of knowledge of both normal cerebral vascular anatomy and normal variants in order to distinguish these from collateral pathways.  Common and uncommon normal variants include:

Primitive connections between internal carotid and posterior fossa

Trigeminal artery

Hypoglossal artery

Stapedial artery

 

Internal carotid artery

Origin of occipital artery

Cervical internal carotid loops or coils

Recurrent artery of Heubner/medial lenticulostriate arteries

Anterior falx artery enlargement

 Origin of ascending pharyngeal artery

Aberrant petrous portion

Cavernous ophthalmic artery origin

Origin of posterior cerebral artery, "fetal origin"

 

External carotid artery

Ophthalmic origin from middle meningeal  

Origin of posterior meningeal artery

 

Circle of Willis

Complete Circle of Willis

 

Basilar artery

Multiple superior cerebellar arteries

Tortuous course of basilar artery

 

Vertebral artery

Isolated posterior inferior cerebellar artery

Inferior thyroid artery origin

Absent vertebral artery

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