A Rare Case of Persistent Trigeminal Artery in an Adult Female With Para Posterior Communicating Artery Aneurysm

Abstract

Anastomosis found in the adulthood between the carotid and vertebro-basilar systems, apart from the posterior communicating artery, are extremely infrequent and are due to the persistence of vessels that joined both systems during the fetal period. This carotidvertebrobasilar anastomosis are the trigeminal, otic, and hypoglossal and proatlantal arteries. Persistent trigeminal artery is the commonest of the above mentioned four arteries. The reported incidence is about 0.2%. Patients may be asymptomatic or present symptoms due to low flow of posterior circulation or carotid microembolization from posterior circulation. PTA can cause trigeminal neuralgia. We report in this paper a case of a persistant trigeminal artery found in an adult female with a para pcom aneurysm who had persistent trigeminal artery which was seen in CT angiogram. KEYWORDS: Persistent, Trigeminal artery, Intracranial aneurysm. KEYMESSAGES: Persistent trigeminal represents one of the persistent fetal arteries in cerebral circulation which communicate between internal carotid and vertebro basilar circulation. While pcom artery is the main communicating artery that persists in an adult, persistent trigeminal artery is seen in a few cases.

Persistent Trigeminal Artery - Anatomical Features and Clinical Significance

“…Aneurysms may also be present in other locations of the cerebral circulation [37]. Patients may present with isolated diplopia (sixth nerve palsy), trigeminal neuralgia, subarachnoid hemorrhage, or carotid cavernous fistula secondary to ruptured aneurysms [1,3,4,15,21,31,32,33,34,42].…”

“…Patients with PTA-associated pathological processes may need surgical treatment. Therefore, the relationship of PTA with the skull base must be well characterized, and CT angiography is a good method for simultaneous visualization of bone and vascular structures [41,42]. Moreover, during the planning of surgical approaches to the skull base, it is important to evaluate the vascular anatomy of the sellar and parasellar regions, searching for PTA.…”