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Persistent trigeminal artery and its variants on MR angiography

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Abstract

Introduction

A persistent trigeminal artery (PTA) is the most common carotid-vertebrobasilar anastomosis. A cerebellar artery that arises from the precavernous segment of the internal carotid artery (ICA) without connecting to the basilar artery is regarded as a PTA variant. Our study aimed to determine the incidence of PTA and its variants and classify them based on magnetic resonance (MR) angiography.

Methods

We retrospectively reviewed cranial images of 3,626 patients who underwent MR angiography in our institution from April 1, 2007 through December 31, 2009. We ultimately reviewed and analyzed images of 3,491 patients (2,066 men, 1,425 women) after excluding 135 with unilateral or bilateral ICA occlusion or suboptimal image quality.

Results

We found 12 cases of PTA (7 men, 5 women; right 4, left 8; incidence; 0.34%) and 6 of PTA variants (3 men, 3 women; right 3, left 3; incidence; 0.17%). 11 of the 12 PTAs were lateral type; 1 was medial. In two of the lateral-type cases, the superior cerebellar artery (SCA) arose from the PTA. Among the six variants, the anterior inferior cerebellar artery (AICA) arose in five and the posterior inferior cerebellar artery (PICA), in one.

Conclusions

On MR angiography, the incidence of PTA was 0.34% and of PTA variants, 0.17%. Left PTA was twice as frequent as right PTA, but with no statistical significance. Medial-type PTA was extremely rare. AICA arose in most PTA variants. Rarely, a lateral-type PTA gave rise to the cerebellar artery.

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References

  1. Arakawa T, Koizumi M, Terashima T et al (2007) Two anatomical autopsy cases of direct communication between a persistent primitive trigeminal artery and an anterior inferior cerebellar artery. Ann Anat 189:489–498

    Article  PubMed  Google Scholar 

  2. Asai K, Hasuo K, Hara T et al (2010) Traumatic persistent trigeminal artery–cavernous sinus fistula treated by transcatheter arterial embolization. A case report. Interv Neuroradiol 16:93–96

    PubMed  CAS  Google Scholar 

  3. Ballantyne ES, Page RD, Meaney JFM et al (1994) Coexistent trigeminal neuralgia, hemifacial spasm, and hypertension: preoperative imaging of neurovascular compression. Case report. J Neurosurg 80:559–563

    Article  PubMed  CAS  Google Scholar 

  4. Baltsavias G, Valavanis A (2010) Endovascular occlusion of a lacerated primitive trigeminal artery during surgical resection of clival chordoma. A case report. Interv Neuroradiol 16:204–207

    PubMed  CAS  Google Scholar 

  5. Baskaya MK, Roberts R, Rivera E et al (2001) Persistent primitive trigeminal artery associated with posterior communicating artery aneurysm and hypoplastic vertebral artery. Surg Radiol Anat 23:169–171

    Article  PubMed  CAS  Google Scholar 

  6. Bosco D, Consoli D, Lanza PL et al (2010) Complete oculomotor palsy caused by persistent trigeminal artery. Neurol Sci 31:657–659

    Article  PubMed  Google Scholar 

  7. Haughton VM, Rosenbaum AE, Pearce J (1978) Internal carotid artery origins of the inferior cerebellar arteries. AJR Am J Roentogenol 130:1191–1192

    CAS  Google Scholar 

  8. Iancu D, Anxionnat R, Bracard S (2010) Brainstem infarction in a patient with internal carotid dissection and persistent trigeminal artery: a case report. BMC Med Imag 10:14

    Article  Google Scholar 

  9. Ikushima I, Arikawa S, Korogi Y et al (2002) Basilar artery aneurysm treated with coil embolization via persistent primitive trigeminal artery. Cardiovasc Intervent Radiol 25:70–71

    Article  PubMed  Google Scholar 

  10. Khodadad G (1976) Persistent trigeminal artery in the fetus. Radiology 121:653–656

    PubMed  CAS  Google Scholar 

  11. Lee KS, Kelly DL Jr (1989) Intrasellar persistent trigeminal artery associated with a pituitary adenoma. Case report. J Neurosurg 70:271–273

    Article  PubMed  CAS  Google Scholar 

  12. Li MH, Li WB, Pan YP et al (2004) Persistent primitive trigeminal artery associated with aneurysm: report of two cases and review of the literature. Acta Radiol 45:664–668

    Article  PubMed  CAS  Google Scholar 

  13. Luh GY, Dean BL, Tomsick TA et al (1999) The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol 172:1427–1432

    PubMed  CAS  Google Scholar 

  14. Meaney JF, Sallomi DF, Miles JB (1994) Transhypophyseal primitive trigeminal artery: demonstration with MRA. J Comput Assist Tomogr 18:991–994

    Article  PubMed  CAS  Google Scholar 

  15. Ohshiro S, Inoue T, Hamada Y et al (1993) Branches of the persistent primitive trigeminal artery—an autopsy case. Neurosurgery 32:144–148

    Article  PubMed  CAS  Google Scholar 

  16. O’uchi E, O’uchi T (2010) Persistent primitive trigeminal arteries (PTA) and its variant (PTAV): analysis of 103 cases detected in 16, 415 cases of MRA over 3 years. Neuroradiology 52:1111–1119

    Article  PubMed  Google Scholar 

  17. Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–261

    Google Scholar 

  18. Piotin M, Miralbes S, Cattin F et al (1996) MRI and MR angiography of persistent trigeminal artery. Neuroradiology 38:730–733

    Article  PubMed  CAS  Google Scholar 

  19. Saltzman GF (1959) Patent primitive trigeminal artery studied by cerebral angiography. Acta Radiol 51:329–336

    Article  PubMed  CAS  Google Scholar 

  20. Scotti G (1975) Anterior inferior cerebellar artery originating from the cavernous portion of the internal carotid artery. Radiology 116:93–94

    PubMed  CAS  Google Scholar 

  21. Siqueira M, Piske R, Ono M et al (1993) Cerebellar arteries originating from the internal carotid artery. AJNR Am J Neuroradiol 14:1229–1235

    PubMed  CAS  Google Scholar 

  22. Suttner N, Mura J, Tedeschi H et al (2000) Persistent trigeminal artery: a unique anatomic specimen—analysis and therapeutic implications. Neurosurgery 47:428–433

    Article  PubMed  CAS  Google Scholar 

  23. Tamura Y, Shimano H, Kuroiwa T et al (2003) Trigeminal neuralgia associated with a primitive trigeminal artery variant: case report. Neurosurgery 52:1217–1220

    Article  PubMed  Google Scholar 

  24. Teal JS, Rumbaugh CL, Bergeron RT et al (1972) Persistent carotid-superior cerebellar artery anastomosis: a variant of persistent trigeminal artery. Radiology 103:335–341

    PubMed  CAS  Google Scholar 

  25. Uchino A, Kato A, Takase Y et al (2000) Persistent trigeminal artery variants detected by MR angiography. Eur Radiol 10:1801–1804

    Article  PubMed  CAS  Google Scholar 

  26. Uchino A, Matsunaga M, Ohno M (1989) Arteriovenous malformation of the corpus callosum associated with persistent primitive trigeminal artery—case report. Neurol Med Chir (Tokyo) 29:429–432

    Article  CAS  Google Scholar 

  27. Uchino A, Saito N, Inoue K (2011) Type 2 proatlantal intersegmental artery associated with persistent trigeminal artery diagnosed by MR angiography. Surg Radiol Anat. doi:10.1007/s00276-011-0839-1

  28. Uchino A, Sawada A, Takase Y et al (2002) Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery. Eur Radiol 12 Suppl 3:S14–S17

    PubMed  CAS  Google Scholar 

  29. Wollschlaeger G, Wollschlaeger PB (1964) The primitive trigeminal artery as seen angiographically and at postmortem examination. Am J Roentgenol Radium Ther Nucl Med 92:761–768

    PubMed  CAS  Google Scholar 

  30. Yang Z, Liu J, Zhao W et al (2010) A fusiform aneurysm of a persistent trigeminal artery variant: case report and literature review. Surg Radiol Anat 32:401–403

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Rosalyn Uhrig, M.A., for editorial assistance in the preparation of this manuscript.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Akira Uchino, Naoko Saito, Yoshitaka Okada, Eito Kozawa, Waka Mizukoshi, Kaiji Inoue & Masahiro Takahashi

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  1. Akira Uchino
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  2. Naoko Saito
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  3. Yoshitaka Okada
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  4. Eito Kozawa
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  5. Waka Mizukoshi
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  6. Kaiji Inoue
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  7. Masahiro Takahashi
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Correspondence to Akira Uchino.

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Uchino, A., Saito, N., Okada, Y. et al. Persistent trigeminal artery and its variants on MR angiography. Surg Radiol Anat 34, 271–276 (2012). https://doi.org/10.1007/s00276-011-0848-0

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  • DOI: https://doi.org/10.1007/s00276-011-0848-0

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