Medial posterior choroidal artery

The medial posterior choroidal artery is a small branch (often multiple - 40% of hemispheres) usually arising from the P2 segment of the posterior cerebral artery (PCA). It may also arise from one of the PCA branches, e.g. parieto-occiptal, calcarine, splenial artery.

It ascends deep to the rest of the PCA and supplies small branches to the tegmentum, midbrain, posterior thalamus and pineal gland as the cisternal segment. It then penetrates the velum interpositum, becoming the plexal segment. It then runs in the roof of the third ventricle supplying the ipsilateral choroid plexus. As it reaches the foramen of Monro it passes through it to anastamose with branches of the lateral posterior choroidal artery.

Medial posterior choroidal artery aneurysm

Aneurysms of the pineal region are rare and theoretically could arise from the medial posterior choroidal artery (MPChoA) or lateral posterior choroidal arteries (LPChoA). A 64-year-old lady with subarachnoid haemorrhage (SAH) and intraventricular haemorrhage (IVH) due to a ruptured MPChoA aneurysm was treated with microsurgical aneurysm excision via an occipital interhemispheric approach. This case demonstrates the importance of being mindful of rare aneurysm locations when initial vascular imaging in SAH appears normal 1)

1)
Hall S, Wang D, Suresh V, Borg N, Bulters D. Ruptured aneurysm of the medial posterior choroidal artery in the pineal region: A rare location easily missed. J Cerebrovasc Endovasc Neurosurg. 2025 Mar 4. doi: 10.7461/jcen.2025.E2024.09.007. Epub ahead of print. PMID: 40033466.