Abstract
Introduction
The aim of this study was to determine the prevalence of persistent trigeminal artery (PTA) associated with trigeminal neuralgia (TN).
Methods
From January 1998 to January 2004, 288 MRI scans of patients examined for trigeminal deficits were retrospectively evaluated. MRI was performed at 1.5 T. Scan protocols included cerebral TSE T2-weighted imaging, contrast enhanced SE T1-weighted imaging and thin-section 3D T2-weighted imaging of the temporal bones, 3D TOF pre- and postcontrast MR angiography. TN was defined as episodes of intense stabbing, electric shock-like pain in areas of the face supplied by the trigeminal branches. Neurovascular compression (NVC) was assumed to be present if the patient showed clinical features of TN, if there was contact between an artery and the trigeminal nerve on the affected side, and if other pathology had been excluded. The prevalence and confidence intervals were calculated (95% CI of the prevalence was based on the exact binomial distribution).
Results
Of 288 patients, 136 matched the criteria for TN. In this series a PTA was detected in three patients, which in all patients was on the same side as the TN. The prevalence of a PTA in patients presenting with TN was 2.2% (CI 0.005–0.06).
Conclusion
Previous studies have shown PTA as an incidental finding in 0.1–0.6% of cerebral angiograms. The prevalence of a PTA in patients with TN was 2.2%. With respect to the clinical significance, a PTA has to be considered in TN and the diagnosis of a PTA can easily be made using MR imaging/angiography.
Similar content being viewed by others
References
Suttner N, Mura J, Tedeschi H et al (2000) Persistent trigeminal artery: a unique anatomic specimen – analysis and therapeutic implications. Neurosurgery 47:428–433; discussion 433–434
Salas E, Ziyal IM, Sekhar LN, Wright DC (1998) Persistent trigeminal artery: an anatomic study. Neurosurgery 43:557–561; discussion 561–562
Ballantyne ES, Page RD, Meaney JF, Nixon TE, Miles JB (1994) Coexistent trigeminal neuralgia, hemifacial spasm, and hypertension: preoperative imaging of neurovascular compression. Case report. J Neurosurg 80:559–563
Zingale A, Chiaramonte I, Mancuso P, Consoli V, Albanese V (1993) Craniofacial pain and incomplete oculomotor palsy associated with ipsilateral primitive trigeminal artery. Case report. J Neurosurg Sci 37:251–255
Ikezaki K, Fujii K, Kishikawa T (1989) Persistent primitive trigeminal artery: a possible cause of trigeminal and abducens nerve palsy. J Neurol Neurosurg Psychiatry 52:1449–1450
Kalidindi RS, Balen F, Hassan A, Al-Din A (2005) Persistent trigeminal artery presenting as intermittent isolated sixth nerve palsy. Clin Radiol 60:515–519
Paksoy Y, Seker M, Kalkan E (2004) Klippel-Feil syndrome associated with persistent trigeminal artery. Spine 29:E193–E196
Battista RA, Kwartler JA, Martinez DM (1997) Persistent trigeminal artery as a cause of dizziness. Ear Nose Throat J 76:43–45
Eadie MJ, Jamieson KG, Lennon EA (1964) Persisting carotid-basilar anastomosis. J Neurol Sci 38:501–511
Uchino A, Kato A, Takase Y, Kudo S (2000) Persistent trigeminal artery variants detected by MR angiography. Eur Radiol 10:1801–1804
Suto Y, Tokuda Y, Kamba M, Ogawa T (1998) Usefulness of MR angiography in detection of persistent trigeminal arteries. Acta Neurol Scand 97:336–340
Kureshi SA, Wilkins RH (1998) Posterior fossa reexploration for persistent or recurrent trigeminal neuralgia or hemifacial spasm: surgical findings and therapeutic implications. Neurosurgery 43:1111–1117
Walchenbach R, Voormolen JH, Hermans J (1994) Microvascular decompression for trigeminal neuralgia: a critical reappraisal. Clin Neurol Neurosurg 96:290–295
Kolluri S, Heros RC (1984) Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol 22:235–240
Eller JL, Raslan AM, Burchiel KJ (2005) Trigeminal neuralgia: definition and classification. Neurosurg Focus 18:E3
Bergouingnan M (1942) Cures heureuses de névralgies faciales essentielles par le diphenyl-hyantoïnate de soude. Rev Laryngol Otol Rhinol 63:34–41
Blom S (1963) Tic douloureux treated with new anticonvulsant; experiences with G 32883. Arch Neurol 9:285–290
Dandy WE (1934) Concerning the cause of trigeminal neuralgia. Am J Surg 24:447–455
Gardner WJ, Miklos MV (1959) Response of trigeminal neuralgia to decompression of sensory root; discussion of cause of trigeminal neuralgia. J Am Med Assoc 170:1773–1776
Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077–1083
Adams CB (1989) Microvascular compression: an alternative view and hypothesis. J Neurosurg 70:1–12
Meaney JF, Eldridge PR, Dunn LT et al (1995) Demonstration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. Comparison with surgical findings in 52 consecutive operative cases. J Neurosurg 83:799–805
Umehara F, Kamishima K, Kashio N et al (1995) Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia. Neuroradiology 37:353–355
Conflict of interest statement
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
de Bondt, BJ., Stokroos, R. & Casselman, J. Persistent trigeminal artery associated with trigeminal neuralgia: hypothesis of neurovascular compression. Neuroradiology 49, 23–26 (2007). https://doi.org/10.1007/s00234-006-0150-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-006-0150-8