Persistent primitive trigeminal artery

Persistent primitive trigeminal artery (PPTA) is one of the persistent carotid-vertebrobasilar anastomoses. It is present in 0.1-0.6% of cerebral angiograms and is usually unilateral.

In utero the trigeminal artery supplies the basilar artery before development of the posterior communicating and vertebral arteries. The PTA arises from the junction between petrous and cavernous ICA, and runs posterolaterally along the trigeminal nerve (41%), or crosses over or through the dorsum sellae (59%). Vertebral, posterior communicating and caudal basilar arteries are often hypoplastic. 

There are 2 types of PTA:

  • Saltzman type I: PTA supplies the distal vertebrobasilar arteries. The PCOM is absent and the caudal BA is absent or hypoplastic with hypolplastic distal vertebral arteries.
  • Saltzman type II: PTA supplies the superior cerebellar arteries with the PCAs supplied by the PCOM.
MRI

A characteristic 'tau sign' or 'trident sign' is described as its appearance on sagittal MR images.

There is an association with intracranial aneurysms and vascular malformations.


Neuroanatomy
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Article Information

rID: 1865
Section: Anatomy
Tags: refs, variant
Synonyms or Alternate Spellings:
  • Persistent trigeminal artery
  • Persistent primitive trigeminal artery (PPTA)

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