Persistent primitive trigeminal artery
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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 the development of the posterior communicating and vertebral arteries. The PPTA arises from the junction between petrous and cavernous ICAinternal carotid artery, 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 3 types of PPTA5:
Saltzman type I: PPTA supplies the distal vertebrobasilar arteries. The posterior communicating artery is absent and the caudal basilar is absent or hypoplastic with hypoplastic distal vertebral arteries.
Saltzman type II: PPTA supplies the superior cerebellar arteries with the posterior cerebral arteries supplied by the posterior communicating artery
.-
Saltzman type III:PPTA
is distinguished by the absence ofdoes not join the basilar arterybetween, instead directly terminating as thePTA originating from the precavernous ICA and its direct connection with atype IIIa: superior cerebellar artery
.The PTA arises from the ICA and directly terminates as the SCA (type IIIa), AICA (typetype IIIb), or: anterior inferior cerebellar arterytype IIIc: posterior inferior cerebellar artery
(type IIIc), without the presence of the basilar artery in between6.
Not all patients fall into this classification, however, with the PPTA supplying the AICA territory also described 5.
Radiographic features
CT/MR angiography
A characteristic tau sign 4 or trident sign is described as its appearance on sagittal CTA or MRA/MRI.
Related pathology
There is an association with intracranial aneurysms and vascular malformations.
See also
-<p><strong>Persistent primitive trigeminal artery (PPTA)</strong> is one of the <a href="/articles/persistent-carotid-vertebrobasilar-anastomoses-2">persistent carotid-vertebrobasilar anastomoses</a>. It is present in 0.1-0.6% of cerebral angiograms and is usually unilateral.</p><p><em>In utero,</em> the trigeminal artery supplies the <a href="/articles/basilar-artery">basilar artery</a> before the development of the <a href="/articles/posterior-communicating-artery">posterior communicating</a> and <a href="/articles/vertebral-artery">vertebral arteries</a>. The PPTA arises from the junction between petrous and cavernous <a href="/articles/ica">ICA</a>, and runs posterolaterally along the <a href="/articles/trigeminal-nerve">trigeminal nerve</a> (41%), or crosses over or through the <a href="/articles/dorsum-sellae">dorsum sellae</a> (59%). Vertebral, posterior communicating and caudal basilar arteries are often hypoplastic. </p><p>There are 3 types of PPTA:</p><ul>- +<p><strong>Persistent primitive trigeminal artery (PPTA)</strong> is one of the <a href="/articles/persistent-carotid-vertebrobasilar-anastomoses-2">persistent carotid-vertebrobasilar anastomoses</a>. It is present in 0.1-0.6% of cerebral angiograms and is usually unilateral.</p><p><em>In utero,</em> the trigeminal artery supplies the <a href="/articles/basilar-artery">basilar artery</a> before the development of the <a href="/articles/posterior-communicating-artery">posterior communicating</a> and <a href="/articles/vertebral-artery">vertebral arteries</a>. The PPTA arises from the junction between petrous and cavernous <a href="/articles/ica">internal carotid artery</a>, and runs posterolaterally along the <a href="/articles/trigeminal-nerve">trigeminal nerve</a> (41%), or crosses over or through the <a href="/articles/dorsum-sellae">dorsum sellae</a> (59%). Vertebral, posterior communicating and caudal basilar arteries are often hypoplastic. </p><p>There are 3 types of PPTA <sup>5</sup>:</p><ul>
-<li><p><strong>Saltzman type II</strong>: PPTA supplies the <a href="/articles/superior-cerebellar-artery">superior cerebellar arteries</a> with the <a href="/articles/posterior-cerebral-artery">posterior cerebral arteries </a>supplied by the posterior communicating artery.</p></li>- +<li><p><strong>Saltzman type II</strong>: PPTA supplies the <a href="/articles/superior-cerebellar-artery">superior cerebellar arteries</a> with the <a href="/articles/posterior-cerebral-artery">posterior cerebral arteries </a>supplied by the posterior communicating artery</p></li>
-<p><strong>Saltzman type III: </strong>PPTA is distinguished by the absence of the basilar artery between the PTA originating from the precavernous ICA and its direct connection with a cerebellar artery.</p>-<p>The PTA arises from the ICA and directly terminates as the SCA (type IIIa), AICA (type IIIb), or posterior inferior cerebellar artery (type IIIc), without the presence of the basilar artery in between <a href="https://pubmed.ncbi.nlm.nih.gov/36237351/" title="6"><sup>6</sup></a>.</p>- +<p><strong>Saltzman type III</strong>:<strong> </strong>PPTA does not join the basilar artery, instead directly terminating as the</p>
- +<ul>
- +<li><p><strong>type IIIa</strong>: superior cerebellar artery</p></li>
- +<li><p><strong>type IIIb</strong>: anterior inferior cerebellar artery</p></li>
- +<li><p><strong>type IIIc</strong>: posterior inferior cerebellar artery</p></li>
- +</ul>
-</ul><p>Not all patients fall into this classification, however, with the PPTA supplying the AICA territory also described <sup>5</sup>. </p><p>Radiographic features</p><p>CT/MR angiography</p><p>A characteristic <a href="/articles/tau-sign">tau sign</a> <sup>4</sup> or <a href="/articles/trident-sign-persistent-primitive-trigeminal-artery">trident sign</a> is described as its appearance on sagittal CTA or MRA/MRI.</p><p>Related pathology</p><p>There is an association with <a href="/articles/saccular-cerebral-aneurysm">intracranial aneurysms</a> and <a href="/articles/cerebrovascular-malformations">vascular malformations</a>.</p><p>See also</p><ul>- +</ul><h4>Radiographic features</h4><h5>CT/MR angiography</h5><p>A characteristic <a href="/articles/tau-sign">tau sign</a> <sup>4</sup> or <a href="/articles/trident-sign-persistent-primitive-trigeminal-artery">trident sign</a> is described as its appearance on sagittal CTA or MRA/MRI.</p><h4>Related pathology</h4><p>There is an association with <a href="/articles/saccular-cerebral-aneurysm">intracranial aneurysms</a> and <a href="/articles/cerebrovascular-malformations">vascular malformations</a>.</p><h4>See also</h4><ul>
References changed:
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