Intrasellar persistent trigeminal artery associated with a pituitary adenoma

Lee, K. Stuart; Kelly, David L.

doi:10.3171/jns.1989.70.2.0271

Cited by 43 publications

(29 citation statements)

References 16 publications

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“…PTA variants are uncommon (2) and are reported to have an incidence of approximately 0.18% (73). In relation to the dorsum sellae, approximately 50 to 59% of all cases of PTA penetrate the sella turcica, course along their own groove, perforate the dura near the clivus, and then join the basilar artery with thinning of the sellar floor and abnormalities of the dorsum sellae being a frequent finding while in the remaining 41 to 50% of cases, the PTA runs lateral to the sella turcica (39,52). In 1993, Ohshiro et al (52) reviewed the relation of PTA to the dorsum sellae in 22 of 25 autopsy cases described up to the time of their writing.…”

Section: Saltzman Classificationmentioning

confidence: 99%

“…About one century elapsed until the artery was angiographically demonstrated for the first time by Sutton in an article published in the British Journal of Radiology in 1950 (75). Persistent trigeminal artery (PTA) is the most common of the primitive carotid-basilar anastomoses that persist into adulthood, with an estimated incidence of 0.1 to 1.0% on cerebral angiograms (17,20,36,39,47,52,67,70). A number of cases of PTA and its variants found at autopsy (21,30, 34,52,60,67,70,82), on cerebral angiograms (2,6,7,17,27, 35,73,85), and on MRI and MRA scans (7,18,63) demonstrate the anatomy (30,39,52,67) of this primitive anastomosis and its relationship to various vascular diseases (1,16,19,20,25,30,36,44,47).…”

Section: Introductionmentioning

confidence: 99%

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Persistent primitive trigeminal artery: a review

Azab

Delashaw²,

Mohammed³

2011

Turkish Neurosurgery

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The trigeminal artery is the largest of the fetal carotid-basilar anastomotic arteries, and it persists for the longest embryonic period. The artery usually involutes after the development of the posterior communicating artery. The exact causes of persistence of this primitive vessel into adulthood are not completely clear. Angiographic and anatomical descriptions of the various persistent trigeminal artery (PTA) configurations and their relation to the remainder of the cerebrovascular tree and the other surrounding structures have been reported. Persistent trigeminal artery can be associated with many other vascular anomalies and disorders including aneurysms, arteriovenous malformations and carotidcavernous fistulae. A thorough understanding of the anatomical and angiographic features of this persistent embryonic arterial channel is of utmost importance when making therapeutic decisions and embarking on surgical or endovascular intervention for any pertinent pathological condition. We review the embryology, angiographic features, microsurgical anatomy and associated vascular anomalies and disorders of the persistent trigeminal artery.

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Section: Saltzman Classificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Persistent primitive trigeminal artery: a review

Azab

Delashaw²,

Mohammed³

2011

Turkish Neurosurgery

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“…Four cases of functional macro-adenoma and one case of non-functional adenoma accompanying PPTA have been reported in the literature [6][7][8][9]. PPTA and accompanying prolactinoma is an extremely rare condition and previously only one case has been reported in the English literature [10].…”

Section: Discussionmentioning

confidence: 99%

“…Although patients are usually asymptomatic, it has been reported that it may accompany third and sixth cranial nerve palsies, aneurysms, vascular anomalies and hemifacial spasm [2][3][4]. The pituitary lesions accompanying PPTA and trigeminal neuralgia (TN) associated with a PPTA are rarely seen [5][6][7][8][9][10]. Knowledge of the typical imaging findings of PPTA prevents major surgical complications [8].…”

Section: Introductionmentioning

confidence: 99%

Persistent primitive trigeminal artery as a cause of trigeminal neuralgia and persistent primitive trigeminal artery associated with pituitary adenoma: Two case reports

Ufuk¹,

Herek²

2017

MMJ

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Persistent primitive trigeminal artery (PPTA) is an abnormal embryonic vascular structure that provides connection between the carotid artery and vertebrobasilar system. PPTA usually originates from cavernous segment of internal carotid artery (ICA) and contacts with the central part of the basilar artery. The sellar lesions such as pituitary adenoma accompanying PPTA are very rare and PPTA is an unusual cause of trigeminal neuralgia. Herein, we present two cases of PPTA along with a prolactin secreting pituitary adenoma and trigeminal neuralgia (TN) due to PPTA, diagnosed by magnetic resonance imaging (MRI). We suggest that MRI would be able to properly plan and execute surgical treatment and avoid cerebral digital subtraction angiography (DSA). Keywords: Magnetic resonance imaging, Persistent trigeminal artery, Prolactinoma, Trigeminal Neuralgia ÖZPersistan primitif trigeminal arter (PPTA), anormal embriyonik vasküler yapı olup karotis arter ve vertebrobasiler sistem arasında bulunur. PPTA sıklıkla internal karotid arterin kavernöz segmentinden kaynaklanmakta olup basiller arterin santral kesimiyle birleşir. Hipofiz adenomları gibi sellar lezyonlara eşlik eden PPTA nadiren görülür ve PPTA, trigeminal nevraljinin nadir bir nedeni olabilir. Biz burada prolaktin salgılayan hipofiz adenomuna eşlik eden PPTA ve trigeminal nevraljiye neden olan PPTA tanısını manyetik rezonans görüntüleme (MRG) ile koyduğumuz iki olgu sunuyoruz. Cerrahi tedavinin planlanmasında ve yol göstermesinde invaziv yöntem olan serebral dijital substraksiyon anjiyografi (DSA)'den kaçarak, yerine MRG'nin kullanılabileceğini düşünüyoruz.

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“…To the best of our knowledge, there are only five reported cases of association between PTA and concomitant pituitary adenoma (8)(9)(10)(11)(12).…”

Section: Sumáriomentioning

confidence: 99%

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Machado

Kodaira

Musolino

2014

Arq Bras Endocrinol Metab

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SUMMARYPersistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas. Arq Bras Endocrinol Metab. 2014;58(6):661-5 SUMÁRIO Persistência da artéria trigeminal (PAT) é a comunicação embrionária mais frequente entre os sistemas carotídeo e vertebrobasilar. No entanto, alterações hormonais ou associação de PAT com outras lesões selares, como adenomas hipofisários, são extremamente raros. O objetivo do presente estudo foi relatar dois pacientes com PAT intrasselar e concomitante adenoma hipofisário e enfatizar a importância para o diagnóstico diferencial de lesões selares. Caso 1. Paciente do sexo feminino, 41 anos, admitida com história de cefaleia crônica (> 20 anos). Ressonância magnética (RM) de hipófise mostrou imagem arredondada na porção esquerda da glândula sugestiva de adenoma (provavelmente adenoma clinicamente não funcionante). Adicionalmente, a RM demonstrou ectasia da artéria carótida interna direita e imagem sugestiva de artéria intrasselar, posteriormente confirmada por angio-RM dos vasos cerebrais como PAT. Caso 2. Paciente do sexo feminino, 42 anos, admitida com história de amenorreia e galactorreia em 1994. A investigação laboratorial revelou hiperprolactinemia. RM de hipófise mostrou pequena área de hipossinal na porção anterior da glândula sugestiva de microadenoma, sendo iniciad...

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Intrasellar persistent trigeminal artery associated with a pituitary adenoma

Abstract: The case of a patient with Cushing's disease and a pituitary macroadenoma, who also had a persistent trigeminal artery coursing through the sella turcica on preoperative imaging studies, is presented. The patient was treated by transsphenoidal resection of the tumor.

Cited by 43 publications

References 16 publications

Persistent primitive trigeminal artery: a review

Persistent primitive trigeminal artery: a review

Persistent primitive trigeminal artery as a cause of trigeminal neuralgia and persistent primitive trigeminal artery associated with pituitary adenoma: Two case reports

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

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