Persistent primitive trigeminal artery: a possible cause of trigeminal and abducens nerve palsy.

Ikezaki, Kaori; Fujii, Kanji; Kishikawa, T

doi:10.1136/jnnp.52.12.1449

Cited by 9 publications

(3 citation statements)

References 6 publications

(1 reference statement)

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“…One theory is that a transient increase in blood flow through the PTA can lead to temporary nerve compression, which can recover within several weeks. 6 , 23 Another theory suggests that nerve compression leads to demyelination and once the nerve conduction returns to normal following ‘remyelination’, the patient’s symptoms improve. 5 , 24 Although the exact mechanism is unknown, these theories are supported by the temporary nature of the diplopia in primary position in our case.…”

Section: Discussionmentioning

confidence: 99%

Persistent Trigeminal Artery Causing an Abducens Nerve Palsy: A Case Report

Lloyd

Jain

Duke

et al. 2022

Neuro-Ophthalmology

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We present a case of a 50-year-old female who was diagnosed with an isolated right abducens nerve palsy and was found to have a persistent trigeminal artery (PTA). The trigeminal artery is the most common persistent embryological carotid-vertebrobasilar anastomosis. A PTA can be picked up as an incidental finding on magnetic resonance imaging (MRI) or angiography. It has been reported that a PTA can be found in 0.1 to 0.6% of all cerebral angiograms. PTA has been linked to several rare abnormalities such as vascular aneurysms and cranial nerve compression. Our patient presented with diplopia and was found to have a paresis of the right lateral rectus muscle consistent with a right abducens nerve palsy. MRI found a right-sided PTA indenting the ventral surface of the pons. This case investigates and highlights that neurovascular compression from a PTA can cause an isolated abducens nerve palsy. Further research is required to investigate if surgical intervention for non-aneurysmal PTA would be beneficial for patients.

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Section: Discussionmentioning

confidence: 99%

Persistent Trigeminal Artery Causing an Abducens Nerve Palsy: A Case Report

Lloyd

Jain

Duke

et al. 2022

Neuro-Ophthalmology

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“…The trigeminal arteries connect the future anterior and posterior cerebral circulations in the embryo [1], Persistence of a single trigem inal artery is observed at angiography in 0.06-0.6% of individuals [2], A persistent trigeminal artery (PTA) is recognised as a potential site for cerebral aneurysms [3], a rare cause of cranial nerve palsies [4] and of trigeminal neuralgia [5]. and as a route by which emboli from the internal carotid artery' may cause brain stem ischaemic events [6].…”

Section: Introductionmentioning

confidence: 99%

“…Aneurysms on a PTA at its origin may rupture into the cavernous sinus giving rise to a 'cavernous sinus syndrome' [10] and the artery' has been implicated as a cause of compressive cranial neuropathy [4] and of trigeminal neuralgia [5]. PTAs may be more frequent in the presence of mental subnormality [17], Recent publication highlight the hazards of transphcnoidal pituitary surgery in the presence of an intrasellar PTA [18].…”

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confidence: 99%

Persistent Trigeminal Artery and Brain Stem Stroke

Zeman¹,

Anslow²,

Greenhall³

1993

Cerebrovasc Dis

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The trigeminal artery provides a transient connection between the developing anterior and posterior cerebral circulations in early embryonic life, but occasionally persists. Its persistence is often associated with hypoplasia of the vertebral arteries. We describe a case of brain stem infarction occurring in a young man with a persistent trigeminal artery. We suggest that persistence of the trigeminal artery is a poorly recognised risk factor for brain stem ischaemia. We briefly review the embryology and complications of persistent trigeminal arteries.

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