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Mercier, "Origin of the perforating arteries of the interpeduncular fossa in relation to the termination of the basilar artery," Interventional Neuroradiology, vol.
Regarding the pathological features of cerebral small vessel disease, Fisher observed the anatomical structures of the deep perforating arteries and noted the presence of diffuse abnormalities in cerebral small blood vessels, calling them "segmental arteriolar disorganization." This disorganization does not simply refer to cerebral small vascular wall thickening or luminal stenosis but to the loss of the normal outer membrane and smooth muscle layer structure and to BBB damage and other abnormalities [31, 53].
This vessel supplies the posterior portion of the temporal lobe and is the origin of several perforating arteries that irrigate the insula.
Amyloid-B deposition in cerebral amyloid angiopathy typically spares the deep perforating arteries making basal ganglia and thalamic microbleeds uncommon [2].
Rate of hemorrhage is approximately 2% to 4% per year (4) and risk of hemorrhage is increased by several factors: intranidal aneurysm, high intranidal pressure from either increased pressure in feeding arteries or restricted outflow in the venous drainage and deep location (characterized by: periventricular/intraventricular or basal ganglian AVMs, central venous drainage, arterial supply from the vertebrobasilar system or perforating arteries).

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