10 Multiple Choice Questions

1. What are the embryological origins of the posterior communicating artery (PComA) and posterior cerebral artery (PCA)?

• A. Anterior cerebral artery
• B. Caudal division of the primitive internal carotid artery
• C. Basilar artery trunk
• D. Vertebral artery fusion

2. Which segment of the PCA extends from the basilar bifurcation to the PComA junction?

• A. P1
• B. P2
• C. P3
• D. P4

3. What is the largest perforating branch of the PComA?

• A. Artery of Percheron
• B. Anterior choroidal artery
• C. Tuberothalamic artery
• D. Thalamogeniculate artery

4. What does “fetal-type PCA” refer to?

• A. PCA supplied predominantly by the basilar artery
• B. PCA supplied predominantly by the internal carotid artery via large PComA
• C. Absent PCA development
• D. Duplicated PCA segments

5. What is the Artery of Percheron?

• A. A branch supplying the cerebellum
• B. A single artery supplying both thalami bilaterally
• C. The main trunk of the PCA
• D. A cortical branch of the MCA

6. Where do aneurysms more frequently develop in asymmetrical basilar artery fusion?

• A. Rostral fusion side
• B. Caudal fusion side
• C. Midline only
• D. Equally on both sides

7. What is “anatomical diversion”?

• A. Pure endovascular coiling technique
• B. Hybrid approach combining bypass surgery with endovascular treatment
• C. Flow diverter stent placement
• D. Direct surgical clipping only

8. What indicates safe PComA sacrifice during procedures?

• A. Negative balloon occlusion test
• B. Positive cross-flow on balloon occlusion test
• C. Absent collateral vessels
• D. Hypoplastic P1 segment

9. What does negative P1 visualization on vertebral angiography indicate?

• A. Normal collateral circulation
• B. Safe for PComA sacrifice
• C. High risk of infarction despite apparent collaterals
• D. Fetal-type PCA configuration

10. Which structures does the tuberothalamic artery supply?

• A. Cerebellum and pons
• B. Anterior thalamus, hypothalamus, and mammillary bodies
• C. Occipital cortex only
• D. Basal ganglia and internal capsule

Answer Key: 1-B, 2-A, 3-C, 4-B, 5-B, 6-B, 7-B, 8-B, 9-C, 10-B