J Cerebrovasc Endovasc Neurosurg.  2016 Jun;18(2):120-123. 10.7461/jcen.2016.18.2.120.

Persistent Primitive Trigeminal Artery That Mimics Persistent Primitive Otic Artery on Cerebral Angiography

• Lee K
• Park H
• Park I
• Han J

• KMID: 2354887
• DOI: http://doi.org/10.7461/jcen.2016.18.2.120

Abstract

Persistent primitive trigeminal artery (PPTA) is the most common carotid-basilar anastomosis; on the other hand, persistent primitive otic artery (PPOA) is extremely rare. PPTA is often misdiagnosed as PPOA on cerebral angiography. We present a case of PPTA that mimicked PPOA on cerebral angiography. We further describe the utility of brain computed tomography angiography for differential diagnosis of PPTA from PPOA, together with a review of previous literature.

Keyword

Persistent cerebral embryonic artery; Cerebral angiography; Computed tomography

MeSH Terms

Angiography
Arteries*
Brain
Central Nervous System Vascular Malformations
Cerebral Angiography*
Diagnosis, Differential
Hand

Figure

• 

  Fig. 1 Anteroposterior (A) and lateral (B) DSA images demonstrating an anastomosis arising from the carotid artery (black arrow) and joining with the middle basilar trunk. DSA = digital subtraction angiography.

• 

  Fig. 2 Sagittal (A) and axial (B) brain CTA images showing that the vessel originates from the petrocavernous junction (white arrow), courses posterolaterally with the trigeminal nerve through Meckel's cave, and inserts into the basilar artery in parallel with the internal acoustic meatus. CTA = computed tomography angiography.

Reference

1. Agnoli AL. Vascular anomalies and subarachnoid haemorrhage associated with persisting embryonic vessels. Acta Neurochir (Wien). 1982; 60(3-4):183–199. PMID: 7072535.

2. Boyko OB, Curnes JT, Blatter DD, Parker DL. MRI of basilar artery hypoplasia associated with persistent primitive trigeminal artery. Neuroradiology. 1996; 1. 38(1):11–14. PMID: 8773267.

3. Brick JF, Roberts T. Cerebral arteriovenous malformation coexistent with intracranial aneurysm and persistent trigeminal artery. South Med J. 1987; 3. 80(3):398–400. PMID: 3824035.

4. Croft HJ. Persistent otic artery. AJNR Am J Neuroradiol. 2004; 1. 25(1):162. author reply 162. PMID: 14729552.

5. George AE, Lin JP, Morantz RA. Intracranial aneurysm on a persistent primitive trigeminal artery. Case report. J Neurosurg. 1971; 11. 35(5):601–604. PMID: 5120008.

6. Hahnel S, Hartmann M, Jansen O, Sartor K. Persistent hypoglossal artery: MRI, MRA and digital subtraction angiography. Neuroradiology. 2001; 9. 43(9):767–769. PMID: 11594429.

7. Kellogg JX, Kuether TA, Horgan MA, Nesbit GM, Barnwell SL. Current concepts on carotid artery-cavernous sinus fistulas. Neurosurg Focus. 1998; 10. 15. 5(4):e12. PMID: 17112211.

8. Kwak R, Kadoya S. Moyamoya disease associated with persistent primitive trigeminal artery. Report of two cases. J Neurosurg. 1983; 7. 59(1):166–171. PMID: 6864274.

9. Lasjaunias PL, Berenstein A, Brugge KGt. Surgical neuroangiography. 2nd ed. Vol. 1. Berlin: New York: Springer;2001. p. 224–228.

10. Luh GY, Dean BL, Tomsick TA, Wallace RC. The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol. 1999; 5. 172(5):1427–1432. PMID: 10227532.

11. Palmer S, Gucer G. Vertebrobasilar insufficiency from carotid disease associated with a trigeminal artery. Neurosurgery. 1981; 4. 8(4):458–461. PMID: 7242898.

12. Patel AB, Gandhi CD, Bederson JB. Angiographic documentation of a persistent otic artery. AJNR Am J Neuroradiol. 2003; 1. 24(1):124–126. PMID: 12533340.

13. Quain R, Maclise J. The anatomy of the arteries of the human body : and its application to pathology and operative surgery, with a series of lithographic drawings. London: Printed for Taylor and Walton;1844. xv:p. 550.

14. Saltzman GF. Patent primitive trigeminal artery studied by cerebral angiography. Acta radiol. 1959; 5. 51(5):329–336. PMID: 13649384.

15. Tubbs RS, Mortazavi MM, Denardo AJ, Cohen-Gadol AA. Persistence of the otic artery with neurological sequelae: case report. Surg Radiol Anat. 012; 3. 34(2):191–193. PMID: 21769634.

16. Yilmaz E, Ilgit E, Taner D. Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat. 1995; 8(1):36–43. PMID: 7697511.