Persistent Trigeminal Artery in Endonasal Resection of Skull Base Tumors: A Systematic Review

Abstract

Primitive persistent trigeminal artery (PTA) is an uncommon embryologic vascular communication between the carotid and basilar arteries, which can be intimately involved by skull base tumors (SBT). Owing to its rarity, skull base surgeons should familiarize themselves with the anatomical variations of PTA to avoid catastrophic complications. To appraise and summarize the available evidence of PTA involved by SBTs while advocating a standardized algorithm for the surgical planning of these patients. MEDLINE and PubMed databases were searched using keywords pertaining to PTA and SBTs. Demographics, clinical presentation, radiographic findings, outcomes, and adverse events were extracted and analyzed. A total of 13 cases between 1973 and 2015 were identified. The mean patient age at presentation was 43 years with predilections toward females and pituitary adenomas. Headaches and endocrine abnormalities were the most common symptoms. The tumors were more frequently associated with Salas medial-type PTA (70%) and Saltzman type-I PTA (31%) than seen in the general population in angiographic studies. We also present a new case of atypical meningioma with Saltzman type-1 PTA. With endoscopic approaches to SBTs becoming more commonplace, surgeons may encounter this anatomical abnormality more frequently. It is important for both otolaryngologists and neurosurgeons to gain a complete understanding of the anatomical variations and neurointerventional capabilities for the successful endoscopic management of these situations.: 4.

Strategy for dealing with unfamiliar and thick vessels during microvascular decompression: A first case report of hemifacial spasm caused by a persistent primitive trigeminal artery

“…[28] The trigeminal artery typically degenerates after development of the posterior communicating artery can be maintained continuously for unclear reasons. [29] The PPTA is commonly derived from the walls of the intracavernous internal carotid artery in a posterolateral or posteromedial direction. [30] Within the cavernous sinus, the PPTA is classified as lateral or medial.…”