Diagnosis: Persistent right trigeminal artery
Persistent right trigeminal artery is the most common carotid-basilar anastomosis. They occur in up to .6% of cerebral angiograms and are almost always unilateral. The trigeminal artery supplies the posterior circulation in utero. As the vertebral arteries and posterior communicators develop, the trigeminal artery regresses. The persistent trigeminal artery may typically arise from the internal carotid artery as it exits the petrous bone and then travels alongside or through the sella before its anastomosis with a basilar artery in 60%. The rest travel laterally along the trigeminal nerve to reach the basilar artery. Associations with persistent trigeminal artery include aneurysms and AVMs. Typically the basilar artery is small proximal to its junction with the persistent trigeminal artery. Primitive hypoglossal artery is the second most common form of fetal anastomosis between the anterior and posterior circulations. This artery connects the basilar artery with the cervical internal carotid artery through the hypoglossal canal. The least common carotid-basilar anastomoses are the proatlantal intersegmental artery and the persistent stapedial artery. Athale SD, Jinkins JR. MRI of persistent trigeminal artery. J Comput Assist Tomogr, Jul-Aug, 1994; 17(4):p551-4.
Silbergleit R, Mehta BA, Barnes RD, et al. Persistent trigeminal artery detected with standard MRI. J Comput Assist Tomogr, Jan-Feb 1993; 17(1):p22-5.
Fortner AA, Smoker WR. Persistent primitive trigeminal artery aneurysm evaluated by MR imaging and angiography. J Comput Assist Tomogr, Sep-Oct 1988; 12(5):p847-50.
Debrun GM, Davis KR, Nauta HJ, et al. Treatment of carotid cavernous fistulae or cavernous aneurysms associated with persistent trigeminal artery: report of three cases. AJNR, Jul-Aug 1988; 9(4):p749-55.
Hirai T, Korogi, Sakamoto Y, et al. MR angiography of the persistent trigeminal artery variant. J Comput Assist Tomogr, May-Jun 1995; 19(3):p495-7.
Fantini GA, Reilly LM, Stoney RJ. Persistent hypoglossal artery: diagnostic and therapeutic considerations concerning carotid thromboendarterectomy. Journal of Vascular Surgery, Dec 1994; 20(6):995-9.
