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Conclusion: Exact knowledge of the variation of Posterior communicating artery is essential not only to explain various neurological symptoms but also for successful micro-vascular surgery in this region.
In our case, we report a rare case of posterior communicating artery aneurysm presenting with writing apraxia.
Available data from the trial also suggest that even very small (less than 7 ram) aneurysms have a potential for hemorrhage that is "noteworthy and certainly far from zero" if they are located in the posterior communicating artery or posterior circulation.
0 ICA = internal carotid artery; ACA=anterior cerebral artery; ACOM = anterior communicating artery; MCA = middle cerebral artery; PICA=posterior inferior cerebellar artery; PCOM = posterior communicating artery; PCA = posterior communicating artery Table 2.
The primary routes of collateral circulation are the Willisian channels (anterior communicating artery, posterior communicating artery, and the ophthalmic via the external carotid artery).
In this sub-arachnoid space, the 3rd nerves pass either side of the midline basilar artery and between two of its major branches--the superior cerebellar and posterior cerebral arteries then just below and lateral to the posterior communicating artery, a key component of the arterial Circle of Willis.
The MCAs were injected with Congo red dye after adequately ligating the distal one-third of the internal carotid artery (ICA) and the proximal one-third of the posterior communicating artery.

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