Fenestrated P1 segment of posterior cerebral artery, partly duplicated posterior communicating artery

PurposeAnatomic variations at the junction of primitive internal carotid and basilar arteries are exceedingly rare. We aimed at reporting such rare variants involving the posterior communicating artery (PComA) and the P1 segment of posterior cerebral artery (PCA).MethodsThe circle of Willis was dissected in an adult cadaver after removal of the cranial vault and cerebral hemispheres.ResultsThe basilar end was rotated axially to the right. The P1 segment of the right PCA was fenestrated and occupied the interpeduncular fossa. The right PComA passed over the oculomotor nerve to join the anterior arm of the P1 fenestration. On the opposite side, the PComA coursed supero-medially to the oculomotor nerve and it had a partly duplicated posterior end, with two arms, medial, larger, and lateral, thinner, inserting successively into the left PCA.ConclusionExtremely rare anatomic variations of the circle of Willis should not be ignored when endovascular or microneurosurgical specific approaches are intended.