This new publication focuses on predictions made by the historic medical illustrator and neuroembryologist, Dorcas Hager Padget. Padget predicted that remnants of the primitive lateral basilovertebral anastomosis (PLBA), a transient channel that interconnects the embryonic branches of the vertebrobasilar system, could contribute to adult neurovascular anomalies. This study reviews the anatomy of the PLBA and describes four types of anatomic variants derived from partial persistence of the PLBA based on a clinical case series. This work introduces novel interpretations of rare variants of the intracranial arterial system. Publication available here: