We sought to determine the prevalence of fetal posterior cerebral artery (
fPCA) and if
fPCA was associated with specific
stroke etiology and vessel territory affected. This paper is a retrospective review of prospectively identified patients with
acute ischemic stroke from July 2008 to December 2010. We defined complete
fPCA as absence of a P1 segment linking the basilar with the PCA and partial
fPCA as small segment linking the basilar with the PCA. Patients without intracranial vascular imaging were excluded. We compared patients with complete
fPCA, partial
fPCA, and without
fPCA in terms of demographics,
stroke severity, distribution, and etiology and factored in whether the
stroke was ipsilateral to the
fPCA. Of the 536 included patients, 9.5% (n = 51) had complete
fPCA and 15.1% (n = 81) had partial
fPCA. Patients with complete
fPCA were older and more often female than partial
fPCA and no
fPCA patients, and significant variation in TOAST classification was detected across groups (P = 0.023). Patients with complete
fPCA had less small vessel and more large vessel
strokes than patients with no
fPCA and partial
fPCA. Fetal PCA may predispose to
stroke mechanism, but is not associated with vascular distribution,
stroke severity, or early outcome.