Persistent Trigeminal Artery Associated with Intracranial Arterial Aneurysm

Abstract

Two patients with persistent trigeminal artery associated with a ruptured arterial intracranial aneurysm arising from the ipsilateral internal carotid artery at the level of the posterior communicating artery are presented. One patient underwent successful clipping of the aneurysm. The other patient died on the x-ray table shortly after admission during the performance of emergency carotid angiography. In each patient, the anomalous vessel was considered to be incidental.

Primitive persistent carotid‐basilar and carotid‐vertebral anastomoses: A report of seven gases and a review of the literature

“…In different angiographic series, the incidence of primitive trigeminal artery is between 0.06% and 0.6% (mean, 0.23%) (Fields, 1968;Krayenbuhl and Yasargil, 1968). It appears highly probable that if undiagnosed or unreported cases are considered, the real incidence of this anomaly is about 1% (Garza-Mercado and Cavazos, 1984). In this study, the incidence of primitive trigeminal artery was found to be 0.11%.…”

“…Among the intracranial vascular anomalies, intracranial aneurysms are most commonly (14%) seen (Sugiyama et al, 1987). T h e majority of the intracranial vascular aneurysms occur on the posterior communicating branch of the internal carotid artery (Garza-Mercado and Cavazos, 1984). Two percent of the cases that are combined with aneurysms have an aneurysm of the primitive trigeminal artery itself (Eggers et al, 1982).…”

“…Similarly, the proatlantal intersegmental artery may cause persistent carotidvertebral anastomosis. Most commonly, these primitive anastomoses are seen in combination with intracranial vascular anomalies and with cranial nerve symptoms such as trigeminal neuralgia (Freitas et al, 1986;Sugiyama et al, 1987;Matsumura et al, 1985;Garza-Mercado and Cavazos, 1984). Furthermore, they appear to be associated with various neurological diseases, such as intracranial tumor, vertebro-basilar insufficiency, multiple sclerosis, subdural hematoma, epilepsy, and moyamoya disease (Kinjo et al, 1988;Knudtzon and Svane, 1987;Lee and Kelly, 1989;Stern et al, 1978;Kwak and Kadoya, 1983;Krmpotic-Nemanic, 1978;Matsumura et al, 1985).…”

A Case of a Traumatic Trigeminal-Cavernous Fistula Occluded by Coil Embolization

“…Spontaneous trigeminal-cavernous fistulas are caused by the rupture of aneurysms, which may be likely formed by the diminished wall resistance of embryological arteries. 6,7 Therapeutic intervention is indicated in most patients, given a prominent venous congestion of the eye, cavernous sinus syndrome with cranial nerve palsies, disturbing pulsatile tinnitus or cardiac problems in case of high shunt volume. In a few early cases, surgical obliteration of the cavernous sinus or ligation of the ICA have been performed.…”

Anomalous communication of external carotid and vertebral arteries with associated intracranial parenchymal arteriovenous malformation: Magnetic resonance angiography and angiographic findings

“…1 Although the persistent carotid or vertebral basilar anastomoses are usually incidental findings, case reports of associated intracranial vascular anomalies have been described, including arteriovenous malformations and aneurysms. [10][11][12] To our knowledge, no vascular anomalies have been described with a PIA. In the present case, it is uncertain whether this represents an associated abnormality or an incidental finding.…”