Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis

Abstract

In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings.

Persistent trigeminal artery in a patient with posterior circulation stroke treated with rt-PA: case report

“…Slight left facial palsy and right hemiparesis2. No new deficits67yo M (2015) [26]Sudden loss of consciousness and quadriplegiaRight cerebral hemisphereRight middle cerebral artery (MCA) and BA occlusion Saltzman type 1Thrombectomy of the MCA and of the BA through the PTALucid and with moderate left hemiparesis67yo M (2015) [27]Sudden loss of consciousness and left hemiparesisNoneRight ICA occlusion with PTA, BA, posterior cerebral artery and superior cerebellar artery hypoperfusion Saltzman type 1rt-PA and thrombectomy through the ICA and PTAMild facial and left hand paresis70yo M (2010) [28]Dysarthria and right hemiparesisLeft pontine infarctionEmbolic occlusion of the PTA Saltzman type 1rt-PANo deficits73yo M (2014) [29]Weakness of the lower extremities, and blindness of the left eyeMultiple infarcts in the anterior and posterior circulation (cardioembolisms)Persistent primitive trigeminal artery, basilar artery hypoplasiaSaltzman type 1UnknownUnknown76yo M(2016) [30]Mild dysmetria and intentional tremor affecting the right arm, tandem gait ataxia, and right-sided hemianopia, preceded several weeks by intermittent vertigoBorder-zone territory between the MCA and the posterior cerebral artery (PCA)Left ICA stenosis (75%) and left PTA, BA hypoplasia below the PTA Saltzman type 1ICA endarterectomyResolution of the intermittent vertigo80yo F (2010) [29]Dysphasia and dysarthria with dizziness and coughRight pontine infarctPTA between left vertebral artery and ipsilateral external carotid artery, right vertebral artery hypoplasiaSaltzman type 2UnknownUnknown…”