J Korean Neurosurg Soc.  2007 Dec;42(6):446-449. 10.3340/jkns.2007.42.6.446.

Persistent Trigeminal Artery Variant Detected by Conventional Angiography and Magnetic Resonance Angiography: Incidence and Clinical Significance

• Rhee SJ
• Kim MS
• Lee CH
• Lee GJ

• KMID: 2189331
• DOI: http://doi.org/10.3340/jkns.2007.42.6.446

Abstract

OBJECTIVE
Persistent trigeminal artery variant (PTAV) is an anastomosis between the internal carotid artery (ICA) and the cerebellar artery without any interposing basilar artery segment. We discuss its probable embryological origin and emphasize clinical implications.
METHODS
Retrospectively 1250 conventional cerebral angiograms and 2947 cranial magnetic resonance angiographies (MRAs) were evaluated for the patients with PTAV.
RESULTS
Five patients (four men and one woman, 23 to 76 years of age, median age 65 years) had a PTAV. Three patients who underwent MRA had a PTAV (3/2947=0.1%). Four of the patients who underwent cerebral angiography had a PTAV (4/1250=0.32%). Two of 143 patients who underwent both conventional angiography and cranial MRA showed PTAV. The PTAV was an incidental finding in all five patients. The PTAV originated from the cavernous segment of the left ICA in four patients and from the cavernous segment of the right ICA in one patient. The terminal branch of the PTAV was the anterior inferior cerebellar artery (AICA) and superior cerebellar artery (SCA) in two patients and the AICA only in the other three patients.
CONCLUSION
Neurosurgeons should be aware of possible presence of PTAV. Manipulation of this vessel during a surgical approach to the parasellar region and percutaneous gasserian ganglion procedure may result in hemorrhage or ischemia.

Keyword

Persistent trigeminal artery variant; Incidence; Clinical implication

MeSH Terms

Angiography*
Arteries*
Basilar Artery
Carotid Artery, Internal
Cerebral Angiography
Female
Hemorrhage
Humans
Incidence*
Incidental Findings
Ischemia
Magnetic Resonance Angiography*
Male
Retrospective Studies
Trigeminal Ganglion