Persistent Trigeminal Artery Associated with Intracranial Vertebral Artery Fenestration in a Patient with Carotid-Cavernous Fistula

2005 ◽  
Vol 18 (2) ◽  
pp. 246-250
Author(s):  
S. Purkayastha ◽  
A.K. Gupta ◽  
E.R. Jayadevan
Keyword(s):  
Vertebral Artery ◽  
Arteriovenous Malformations ◽  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Vertebral Arteries

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.

PERSISTENT TRIGEMINAL ARTERY TERMINATING IN THE POSTERIOR INFERIOR CEREBELLAR ARTERY

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. E746-E748 ◽  
Author(s):  
Saad Ali ◽  
Majdi M. Radaideh ◽  
Ali Shaibani ◽  
Eric J. Russell ◽  
Matthew T. Walker
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Hemisphere ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Cerebellar Artery

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.

scholarly journals Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

2012 ◽  
Vol 01 (01) ◽  
pp. 072-074
Author(s):  
Anthony Sin ◽  
Hugo Cuellar ◽  
Benjamin Brown
Keyword(s):  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Trigeminal Artery ◽  
Carotid Cavernous Fistula ◽  
Unique Challenge ◽  
Cavernous Fistula ◽  
Catheter Technique ◽  
Safe Treatment Option

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.

scholarly journals Transvenous Embolization of Primitive Trigeminal Artery Variant-Cavernous Fistula with Guglielmi Detachable Coils

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 95-98 ◽  
Author(s):  
Yi-Ming Wu ◽  
Ho-Fai Wong
Keyword(s):  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Inferior Petrosal Sinus ◽  
Digital Subtraction ◽  
Trigeminal Artery ◽  
Guglielmi Detachable Coils ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Detachable Coils ◽  
Primitive Trigeminal Artery

Here, we present a 32-year-old male with proptosis and chemosis of the left eye following a close head injury. Digital subtraction angiography of the left internal carotid artery showed a left carotid-cavernous fistula (CCF) associated with a primitive trigeminal artery (PTA) variant. The patient was successfully treated with transvenous Guglielmi detachable coils embolization via the inferior petrosal sinus. The PTA variant was preserved without cerebellar or brainstem infarct.

Contralateral Ocular Manifestations of a Carotid Cavernous Fistula Associated With Primitive Persistent Trigeminal Artery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Tung Thanh Hoang ◽  
Cuong Ngoc Nguyen ◽  
Anh Quoc Nguyen ◽  
Hieu Lan Nguyen ◽  
Prem S. Subramanian ◽  
...  
Keyword(s):  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Ocular Manifestations

scholarly journals Endovascular Coil Occlusion of Traumatic Intradural Aneurysm with Presentation as Carotid Cavernous Fistula

2014 ◽  
Vol 4 ◽  
pp. 11 ◽  
Author(s):  
Lakshmi S P Karanam ◽  
Anand B Alurkar ◽  
M Natarajan ◽  
B Pugazhenthi
Keyword(s):  
Intracranial Aneurysms ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Endovascular Embolization ◽  
Traumatic Aneurysm ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Coil Occlusion ◽  
Surgical Methods ◽  
Post Traumatic

Carotid cavernous fistulae (CCF) are abnormal communication between cavernous segment of the internal carotid artery and cavernous sinus. These entities are usually encountered in 0.2-0.8% of patients with traumatic skull base fractures. Traumatic cerebral aneurysms are rare and account for less than 1% of intracranial aneurysms. CCF due to ruptured intradural traumatic aneurysm is very rare and difficult to treat by surgical methods. We present one such case of a 40-year-old man with post-traumatic CCF due to a ruptured intradural aneurysm successfully treated with endovascular embolization.

Persistent Trigeminal Artery as a Cause of Dizziness

1997 ◽  
Vol 76 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Robert A. Battista ◽  
Jed A. Kwartler ◽  
Daniel M. Martinez
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Persistent Trigeminal Artery ◽  
Vertebrobasilar Insufficiency ◽  
Trigeminal Artery ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Common Problems ◽  
Artery Disease

Complaints of vertigo and dizziness are common problems referred to otolaryngologists for evaluation. Awareness of uncommon causes of dizziness increases the physician's ability to diagnose and treat these patients. We present the case of a middle-aged woman who presented with episodes of vertigo and symptoms suggestive of vertebrobasilar insufficiency. These symptoms were the result of a persistent trigeminal artery (PTA) and occlusive carotid artery disease. A PTA is a carotid-basilar anastomosis that has been reported to be demonstrated on 0.1% to 0.6% of all cerebral angiograms. Persistence of this vessel usually leads to hypoplasia or agenesis of the ipsilateral posterior communicating artery, and leaves the internal carotid artery as the main source of blood supply to the region of the upper brainstem. The appearance and clinical significance of this unusual condition will be discussed.

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