Unilateral Carotid-Cavernous Fistula Associated With Primitive Persistent Trigeminal Artery Leading to Bilateral Ophthalmic Presentations

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Tung T. Hoang ◽  
Cuong N. Nguyen ◽  
Hieu L. Nguyen ◽  
Prem S. Subramanian
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Tung Thanh Hoang ◽  
Cuong Ngoc Nguyen ◽  
Anh Quoc Nguyen ◽  
Hieu Lan Nguyen ◽  
Prem S. Subramanian ◽  
...  

2005 ◽  
Vol 18 (2) ◽  
pp. 246-250
Author(s):  
S. Purkayastha ◽  
A.K. Gupta ◽  
E.R. Jayadevan

The association of persistent trigeminal artery (PTA) with intracranial vertebral artery fenestration is very rare. The commonest associations of PTA are with intracranial aneurysms, arteriovenous malformations, absence of internal carotid artery and vertebral arteries. We describe a case of persistent trigeminal artery associated with intracranial vertebral artery fenestration in a patient with right-sided type 1 carotid-cavernous fistula. To our knowledge, this is the first report of such an association.


Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. E746-E748 ◽  
Author(s):  
Saad Ali ◽  
Majdi M. Radaideh ◽  
Ali Shaibani ◽  
Eric J. Russell ◽  
Matthew T. Walker

Abstract OBJECTIVE Persistent trigeminal arteries are rare and represent a remnant of the fetal carotid-basilar circulation. They typically extend from the internal carotid artery to the basilar artery. An unusual case of a patient with a trigeminal artery originating from the internal carotid artery and terminating as the dominant hemispheric branch of the posterior inferior cerebellar artery is presented. CLINICAL PRESENTATION A 66-year-old woman presented to the emergency department with pulsatile tinnitus, increasing left eye pain, proptosis, conjunctival injection, diplopia, and decreased visual acuity. Conventional contrast-enhanced computed tomographic and magnetic resonance imaging demonstrated findings consistent with a left carotid-cavernous fistula. The patient underwent an emergency diagnostic cerebral angiogram. Besides an indirect carotid-cavernous fistula on the left side, a right-sided persistent trigeminal artery terminating as the dominant hemispheric trunk of the posteroinferior cerebellar artery was incidentally noted. The vermian branch of the right posteroinferior cerebellar artery arose from the ipsilateral vertebral artery, whereas duplicate superior cerebellar arteries supplied the left posteroinferior cerebellar artery region. INTERVENTION The patient was treated for the indirect carotid-cavernous fistula with detachable platinum coils and N-butyl cyanoacrylate, resulting in the resolution of her symptoms. CONCLUSION We report a case of a persistent trigeminal artery supplying only the cerebellar hemisphere. The clinical significance of this anomaly relates to its role in endovascular therapeutic and surgical complications and the paradoxical lesions in the cerebellum that occur as a result of carotid disease. We also discuss the Saltzman classification of persistent trigeminal arteries and their variants.


2012 ◽  
Vol 01 (01) ◽  
pp. 072-074
Author(s):  
Anthony Sin ◽  
Hugo Cuellar ◽  
Benjamin Brown

Abstract We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA) laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.


2001 ◽  
Vol 7 (1) ◽  
pp. 47-50 ◽  
Author(s):  
P.S. Deol ◽  
N.K. Mishra ◽  
V. Gupta ◽  
S.B. Gaikwad ◽  
A. Garg ◽  
...  

A case of traumatic persistent primitive trigeminal artery (PPTA) cavernous sinus fistula treated with GDC embolisation is reported. Because of the small lumen of PPTA, posteriorly directed course and flow contribution from the posterior circulation, balloon embolisation via the carotid system was not considered appropriate. The fistula was successfully closed by GDC embolisation.


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