Partial persistence of the primitive lateral basilovertebral anastomosis of Padget

Franco et al discuss the case study of a 30-year-old man with vertigo and multidirectional nystagmus lasting 30 days. Magnetic Resonance Imaging (MRI) showed subacute vermian infarction. He underwent digital subtraction angiography, which revealed duplication of the vertebrobasilar circulation through a branch of the right vertebral artery, connected to the main circulation by a hypoplastic branch, compatible with partial persistence of the primitive lateral basilovertebral anastomosis of Padget (PLBA) originating the left posterior inferior cerebellar artery, an embryonic remnant. PLBA persistence increases stroke chances because of the abnormal pattern of arterial supply territories and subsequent deficient collaterality.