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Published in: Surgical and Radiologic Anatomy 8/2023

20-06-2023 | MR Angiography | Anatomic Variations

Persistent trigeminal artery–superior cerebellar artery segmental fusion diagnosed using magnetic resonance angiography

Authors: Shu Suzuki, Akira Uchino, Akira Kunimatsu

Published in: Surgical and Radiologic Anatomy | Issue 8/2023

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Abstract

Purpose

To describe a case of persistent trigeminal artery (PTA)–superior cerebellar artery (SCA) segmental fusion incidentally diagnosed on magnetic resonance (MR) angiography.

Case report

A 53-year-old woman with a history of facial pain underwent cranial MR imaging and MR angiography. MR angiography showed a left lateral-type PTA arising from the precavernous portion of the left internal carotid artery (ICA). PTA branched into the left distal SCA and showed segmental fusion with the proximal SCA at the distal part of the PTA. We also diagnosed an unruptured cerebral aneurysm at the junction between the left ICA and PTA.

Discussion

PTA is the most frequent type of carotid-vertebrobasilar anastomosis. The reported prevalence rate is 0.2% by angiography and 0.34% by MR angiography. There are two types of PTA—lateral (usual) and medial (intrasellar). SCA arising from the lateral-type PTA has rarely been reported. Further, a PTA from which the distal SCA branches and segmentally fuses with the proximal SCA at the distal part of the PTA has not been reported.

Conclusion

Using MR angiography, we diagnosed a rare type of PTA that fused segmentally with SCA. No similar case has been reported in relevant English-language literature.
Literature
1.
go back to reference Ali S, Radaideh MM, Shaibani A, Russell EJ, Walker MT (2008) Persistent trigeminal artery terminating in the posterior inferior cerebellar artery: case report. Neurosurgery 62:E746-748CrossRefPubMed Ali S, Radaideh MM, Shaibani A, Russell EJ, Walker MT (2008) Persistent trigeminal artery terminating in the posterior inferior cerebellar artery: case report. Neurosurgery 62:E746-748CrossRefPubMed
2.
go back to reference Amaniego EA, Dabus G, Andreone V, Linfante I (2011) Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage. J Neurointerv Surg 3:282–284CrossRef Amaniego EA, Dabus G, Andreone V, Linfante I (2011) Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage. J Neurointerv Surg 3:282–284CrossRef
3.
go back to reference Diana F, Mangiafico S, Valente V, Wlderk A, Grillea G, Colonnese C, Bartolo M (2019) Persistent trigeminal artery aneurysms: case report and systematic review. J Neurointerv Surg 11:1261–1265CrossRefPubMed Diana F, Mangiafico S, Valente V, Wlderk A, Grillea G, Colonnese C, Bartolo M (2019) Persistent trigeminal artery aneurysms: case report and systematic review. J Neurointerv Surg 11:1261–1265CrossRefPubMed
4.
go back to reference Lee KS, Kelly DL Jr (1989) Intrasellar persistent trigeminal artery associated with a pituitary adenoma. Case report. J Neurosurg 70:271–273CrossRefPubMed Lee KS, Kelly DL Jr (1989) Intrasellar persistent trigeminal artery associated with a pituitary adenoma. Case report. J Neurosurg 70:271–273CrossRefPubMed
5.
go back to reference Luh GY, Dean BL, Tomsick TA et al (1999) The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol 172:1427–1432CrossRefPubMed Luh GY, Dean BL, Tomsick TA et al (1999) The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol 172:1427–1432CrossRefPubMed
6.
go back to reference Meaney JF, Sallomi DF, Miles JB (1994) Transhypophyseal primitive trigeminal artery: demonstration with MRA. J Comput Assist Tomogr 18:991–994CrossRefPubMed Meaney JF, Sallomi DF, Miles JB (1994) Transhypophyseal primitive trigeminal artery: demonstration with MRA. J Comput Assist Tomogr 18:991–994CrossRefPubMed
7.
go back to reference 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 52:1111–1119CrossRefPubMed 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 52:1111–1119CrossRefPubMed
8.
go back to reference Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–261 Padget DH (1948) The development of the cranial arteries in the human embryo. Contrib Embryol 32:205–261
9.
go back to reference Salas E, Ziyal IM, Sekhar LN, Wright DC (1998) Persistent trigeminal artery: an anatomic study. Neurosurgery 43:557–562CrossRefPubMed Salas E, Ziyal IM, Sekhar LN, Wright DC (1998) Persistent trigeminal artery: an anatomic study. Neurosurgery 43:557–562CrossRefPubMed
10.
go back to reference Saltzman GF (1959) Patent primitive trigeminal artery studied by cerebral angiography. Acta Radiol 51:329–336CrossRefPubMed Saltzman GF (1959) Patent primitive trigeminal artery studied by cerebral angiography. Acta Radiol 51:329–336CrossRefPubMed
11.
go back to reference Sano K, Kuge A, Kondo R, Yamaki T, Shimokawa Y, Saito S, Sonoda Y (2020) Trigeminal neuralgia due to compression of primitive trigeminal artery variant: usefulness of fusion images of constructive interference in steady-state magnetic resonance imaging and computed tomography angiography. World Neurosurg 138:257–260CrossRefPubMed Sano K, Kuge A, Kondo R, Yamaki T, Shimokawa Y, Saito S, Sonoda Y (2020) Trigeminal neuralgia due to compression of primitive trigeminal artery variant: usefulness of fusion images of constructive interference in steady-state magnetic resonance imaging and computed tomography angiography. World Neurosurg 138:257–260CrossRefPubMed
12.
go back to reference Teal JS, Rumbaugh CL, Bergeron RT et al (1972) Persistent carotid-superior cerebellar artery anastomosis: a variant of persistent trigeminal artery. Radiology 103:335–341CrossRefPubMed Teal JS, Rumbaugh CL, Bergeron RT et al (1972) Persistent carotid-superior cerebellar artery anastomosis: a variant of persistent trigeminal artery. Radiology 103:335–341CrossRefPubMed
13.
go back to reference Uchino A, Saito N, Okada Y, Kozawa E, Mizukoshi W, Inoue K, Takahashi M (2012) Persistent trigeminal artery and its variants on MR angiography. Surg Radiol Anat 34:271–276CrossRefPubMed Uchino A, Saito N, Okada Y, Kozawa E, Mizukoshi W, Inoue K, Takahashi M (2012) Persistent trigeminal artery and its variants on MR angiography. Surg Radiol Anat 34:271–276CrossRefPubMed
Metadata
Title
Persistent trigeminal artery–superior cerebellar artery segmental fusion diagnosed using magnetic resonance angiography
Authors
Shu Suzuki
Akira Uchino
Akira Kunimatsu
Publication date
20-06-2023
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 8/2023
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-023-03182-z

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