Abstract
A 61-year-old woman presented with typical trigeminal neuralgia (TN), caused by an aberrant posterior inferior cerebellar artery (PICA) associated with the primitive trigeminal artery (PTA). Magnetic resonance angiography and digital subtraction angiography clearly showed an anomalous artery directly originating from the PTA and coursing into the PICA territory at the cerebellum. During microvascular decompression (MVD), we confirmed and decompressed vascular compression of the trigeminal nerve by this anomalous, PICA-variant type of PTA. The PTA did not conflict with the trigeminal nerve, and the anomalous PICA only compressed the caudolateral part of the trigeminal nerve, without the more common compression at its root entry zone. This case is informative due not only to its very unusual angioanatomical variation but also to its helpfulness for surgeons preparing a MVD for a TN associated with such a rare vascular anomaly.
Similar content being viewed by others
References
Pamir MN, Peker S. Microvascular decompression for trigeminal neuralgia: a long-term follow-up study. Minim Invasive Neurosurg. 2006;49(6):342–6.
Barker 2nd FG, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334(17):1077–83.
Morita A, Fukushima T, Miyazaki S, Shimizu T, Atsuchi M. Tic douloureux caused by primitive trigeminal artery or its variant. J Neurosurg. 1989;70(3):415–9.
Ito J, Takeda N, Suzuki Y, Tekeuchi S, Osugi S, Yoshida Y. Anomalous origin of the anterior inferior cerebellar arteries from the internal carotid artery. Neuroradiology. 1980;19(2):105–9.
Yamada Y, Kondo A, Tanabe H. Trigeminal neuralgia associated with an anomalous artery originating from the persistent primitive trigeminal artery. Neurol Med Chir Tokyo. 2006;46(4):194–7.
Ali S, Radaideh MM, Shaibani A, Russell EJ, Walker MT. Persistent trigeminal artery terminating in the posterior inferior cerebellar artery: case report. Neurosurgery. 2008;62(3):E746–8. discussion E-8.
Chidambaranathan N, Sayeed ZA, Sunder K, Meera K. Persistent trigeminal artery: a rare cause of trigeminal neuralgia-MR imaging. Neurol India. 2006;54(2):226–7.
Silver J, Wilkins R. Persistent embryonic intracranial and extracranial vessels. In: Wilkins R, Rengachary SS, (eds.). 2nd ed. New York: McGraw-Hill; 1996.
McKenzie JD, Dean BL, Flom RA. Trigeminal-cavernous fistula: Saltzman anatomy revisited. AJNR Am J Neuroradiol. 1996;17(2):280–2.
Saltzman GF. Patent primitive trigeminal artery studied by cerebral angiography. Acta Radiol. 1959;51(5):329–36.
Siqueira M, Piske R, Ono M, Marino Jr R. Cerebellar arteries originating from the internal carotid artery. AJNR Am J Neuroradiol. 1993;14(5):1229–35.
Haughton VM, Rosenbaum AE, Pearce J. Internal carotid artery origins of the inferior cerebellar arteries. AJR Am J Roentgenol. 1978;130(6):1191–2.
George AE, Lin JP, Morantz RA. Intracranial aneurysm on a persistent primitive trigeminal artery. Case report. J Neurosurg. 1971;35(5):601–4.
Tamura Y, Shimano H, Kuroiwa T, Miki Y. Trigeminal neuralgia associated with a primitive trigeminal artery variant: case report. Neurosurgery. 2003;52(5):1217–9. discussion 9-20.
Tokimura H, Atsuchi M, Kawasaki T, Sato E, Todoroki K, Asakura T, et al. Trigeminal neuralgia associated with primitive trigeminal artery: report of two cases. No Shinkei Geka. 1990;18(2):209–13.
Conflict of interest
There is nothing to declare as conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, S.H., Koh, J.S. & Lee, C.Y. Trigeminal Neuralgia Caused by an Anomalous Posterior Inferior Cerebellar Artery from the Primitive Trigeminal Artery: Case Report. Cerebellum 10, 199–203 (2011). https://doi.org/10.1007/s12311-011-0249-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12311-011-0249-2