Skip to main content


Log in

The artery of Percheron revisited: a cadaveric anatomical study

  • Experimental research - Vascular
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript



The artery of Percheron (AOP) is a single thalamoperforating arterial trunk that provides bilateral supply to the paramedian thalami and the rostral midbrain. As this rare anatomical variant artery may be involved in endovascular procedures or encountered surgically during basilar terminus aneurysms, the present study was warranted.


Thirty-four adult (20 male and 14 female) formalin-fixed cadaveric brains underwent dissection of the 68 posterior cerebral arteries. Observations were made of the presence and the variations of the thalamoperforating arteries as well as the presence of the AOP.


Thalamoperforating arteries arose from the superior or posterior surfaces of the P1 segment at a mean of a 1.87 mm (range, 0.39–5.25 mm) distance from the basilar apex and entered the brain through the posterior perforated substance. The average number was 4.25 (range 1–9), and the mean diameter was 0.73 mm (range 0.46–1.16 mm). Thalamoperforating arteries were classified into four different types according to their origin at the P1 segment: type I (bilateral multiple, n = 19), 55.8 %; type II (unilateral multiple, unilateral single, n = 4), 11.7 %; type III (bilateral single, n = 7), 20.5 %; type IV [one side with a single branch, the other side with no branches (the AOP), n = 4], 11.7 %. In three separate specimens with ruptured basilar artery aneurysms, the origin of the thalamoperforating arteries was incorporated not only into the posterior aspect of the aneurysm neck but also into the fundus.


In about one tenth of cases the possibility of the presence of a single arterial trunk that supplies the two paramedian thalamic territories should be taken into consideration during treatment planning of basilar terminus aneurysms. Furthermore, our data show that the thalamoperforating arteries may take off from both the aneurysm neck and the fundus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others


  1. Abdel Aziz KM, Andaluz N, Zuccarello M (2007) Basilar bifurcation aneurysms: strategies for surgical approach selection. Neurosurg Q 17:101–112

    Article  Google Scholar 

  2. Brassier G, Morandi X, Fournier D, Velut S, Mercier P (1998) Origin of the perforating arteries of the interpeduncular fossa in relation to the termination of the basilar artery. Interv Neuroradiol 4:109–120

    PubMed  CAS  Google Scholar 

  3. Caruso G, Vincentelli F, Giudicelli G, Grisoli F, Xu T, Gouaze A (1990) Perforating branches of the basilar bifurcation. J Neurosurg 73:259–265

    Article  PubMed  CAS  Google Scholar 

  4. Gentilini M, De Renzi E, Crisi G (1987) Bilateral paramedian thalamic artery infarcts: report of eight cases. J Neurol Neurosurg Psychiatry 50:900–909

    Article  PubMed  CAS  Google Scholar 

  5. Kaplan HA, Ford DH (1996) The brain vascular system. Elsevier, Amsterdam, pp 70–81

    Google Scholar 

  6. Kaya AH, Dagcinar A, Ulu MO, Topal A, Bayri Y, Ulus A, Kopuz C, Sam B (2010) The perforating branches of the P1 segment of the posterior cerebral artery. J Clin Neurosci 17:80–84

    Article  PubMed  Google Scholar 

  7. Kostanian V, Cramer SC (2007) Artery of Percheron thrombolysis. AJNR 28:870–871

    PubMed  CAS  Google Scholar 

  8. Krayenbühl HA, Yaşargil MG (1968) Cerebral angiography, 2nd edn. JB Lippincott, Philadelphia, pp 20–84

    Google Scholar 

  9. Krampla W, Schmidbauer B, Hruby W (2008) Ischemic stroke of the artery of Percheron (2007:10b). Eur Radiol 18:192–194

    Article  PubMed  CAS  Google Scholar 

  10. Krisht AF, Krayenbühl N, Sercl D, Bikmaz K, Kadri PA (2007) Results of microsurgical clipping of 50 high complexity basilar apex aneurysms. Neurosurgery 60:242–250

    Article  PubMed  Google Scholar 

  11. Lang J, Brunner FX (1978) Über die rami centrales der aa. Cerebri anterior and media. Gegenbaurs Morph Jb 124:364

    CAS  Google Scholar 

  12. Lazzaro NA, Wright B, Castillo M, Fischbein NJ, Glastonbury CM, Hildenbrand PG, Wiggins RH, Quigley EP, Osborn AG (2010) Artery of Percheron infarction: imaging patterns and clinical spectrum. AJNR 31:1283–1289

    Article  PubMed  Google Scholar 

  13. Marinkovic S, Milisavljevic M, Kovacevic M (1986) Interpeduncular perforating branches of the posterior cerebral artery: the microsurgical anatomy of their extracerebral and intracerebral segments. Surg Neurol 26:349–359

    Article  PubMed  CAS  Google Scholar 

  14. Marinkovic S, Gibo H, Milisavljevic M (1996) The surgical anatomy of relationships between the perforating and the leptomeningeal arteries. Neurosurgery 39:72–83

    Article  PubMed  CAS  Google Scholar 

  15. Matheus G, Castillo M (2003) Imaging of acute bilateral paramedian thalamic and mesencephalic infarcts. AJNR 24:2005–2008

    PubMed  Google Scholar 

  16. Park SQ, Bae HG, Yoon SM, Shim JJ, Yun IG, Choi SK (2010) Morphological characteristics of thalamoperforating arteries. J Korean Neurosurg Soc 47:36–41

    Article  PubMed  Google Scholar 

  17. Pedroza A, Dujovny M, Ausman JI, Diaz FG, Cabezudo Artero J, Berman SK, Mirchandani HG, Umansky F (1986) Microvascular anatomy of the interpeduncular fossa. J Neurosurg 64:484–493

    Article  PubMed  CAS  Google Scholar 

  18. Peluso JP, van Rooij WJ, Sluzewski M, Beute G (2008) Coiling of basilar tip aneurysms: results in 154 consecutive patients with emphasis on recurrent haemorrhage and re-treatment during mid- and long-term follow up. J Neurol Neurosurg Psychiatry 79:706–711

    Article  PubMed  CAS  Google Scholar 

  19. Percheron G (1973) The anatomy of the arterial supply of the human thalamus and its use for the interpretation of the thalamic vascular pathology. Z Neurol 205:1–13

    Article  PubMed  CAS  Google Scholar 

  20. Percheron G (1976) Arteries of the human thalamus. I. Artery and polar thalamic territory of the posterior communicating artery [in French]. Rev Neurol (Paris) 132:297–307

    CAS  Google Scholar 

  21. Percheron G (1976) Arteries of the human thalamus. I. Artery and polar thalamic territory of the posterior communicating artery [in French]. Rev Neurol (Paris) 132:309–324

    CAS  Google Scholar 

  22. Rangel-Castilla L, Gasco J, Thompson B, Salinas P (2009) Bilateral paramedian thalamic and mesencephalic infarcts after basilar tip aneurysm coiling: role of the artery of Percheron. Neurocirugia (Astur) 20:288–293

    CAS  Google Scholar 

  23. Roitberg BZ, Tuccar E, Alp MS (2002) Bilateral paramedian thalamic infarct in the presence of an unpaired thalamic perforating artery. Acta Neurochir (Wien) 144:301–304

    Article  CAS  Google Scholar 

  24. Saeki N, Rhoton AL Jr (1977) Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg 46:563–578

    Article  PubMed  CAS  Google Scholar 

  25. Sanai N, Tarapore P, Lee AC, Lawton MT (2008) The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era. Neurosurgery 62:1236–1249

    Article  PubMed  Google Scholar 

  26. Uz A (2007) Variations in the origin of the thalamoperforating arteries. J Clin Neurosci 14:124–137

    Article  Google Scholar 

  27. Yaşargil MG, Antic J, Laciga R, Jain KK, Hodosh RM, Smith RD (1976) Microsurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol 6:83–91

    PubMed  Google Scholar 

  28. Zeal AA, Rhoton AL Jr (1978) Microsurgical anatomy of the posterior cerebral artery. J Neurosurg 48:534–559

    Article  PubMed  CAS  Google Scholar 

Download references


Part of this study was presented as a poster at the Joint Meeting of Anatomical Societies held from 19–22 May 2011 in Bursa, Turkey.

Conflicts of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to Hasan Kocaeli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kocaeli, H., Yılmazlar, S., Kuytu, T. et al. The artery of Percheron revisited: a cadaveric anatomical study. Acta Neurochir 155, 533–539 (2013).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: