Persistent primitive trigeminal artery
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View Ryan Thibodeau's current disclosures- Persistent trigeminal artery
- Persistent primitive trigeminal artery (PPTA)
Persistent primitive trigeminal artery (PPTA) is the most common type of the four persistent carotid-vertebrobasilar anastomoses. It is present in 0.1-0.6% of cerebral angiograms and is usually unilateral 2.
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 segments of the internal 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.
On this page:
Classification
There are 3 types of PPTA 5:
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 does not join the basilar artery, instead directly terminating as the
type IIIa: superior cerebellar artery
type IIIb: anterior inferior cerebellar artery
type IIIc: posterior inferior cerebellar artery
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
References
- 1. Anne G. Osborn. Diagnostic Neuroradiology. (1994) ISBN: 0801674867 - Google Books
- 2. Dimmick S & Faulder K. Normal Variants of the Cerebral Circulation at Multidetector CT Angiography. Radiographics. 2009;29(4):1027-43. doi:10.1148/rg.294085730 - Pubmed
- 3. Zampakis P, Panagiotopoulos V, Petsas T, Kalogeropoulou C. Common and Uncommon Intracranial Arterial Anatomic Variations in Multi-Detector Computed Tomography Angiography (MDCTA). What Radiologists Should Be Aware Of. Insights Imaging. 2015;6(1):33-42. doi:10.1007/s13244-014-0381-x - Pubmed
- 4. Goyal M. The Tau Sign. Radiology. 2001;220(3):618-9. doi:10.1148/radiol.2202991498 - Pubmed
- 5. Wang Y & Yu J. Clinical Importance of the Persistent Primitive Trigeminal Artery in Vascular Lesions and Its Role in Endovascular Treatment. Front Neurol. 2022;13:928608. doi:10.3389/fneur.2022.928608 - Pubmed
Incoming Links
- T sign (obstetrics)
- Persistent hypoglossal artery
- PHACE syndrome
- Persistent carotid-vertebrobasilar anastomoses
- Persistent otic artery
- Circle of Willis
- Intracranial arteries (variants)
- Persistent communications between the carotid and vertebrobasilar arteries (mnemonic)
- Tau sign
- Trident sign (persistent primitive trigeminal artery)
- Primitive arteries in the brain (mnemonic)
- Persistent trigeminal artery
- Persistent carotid-vertebrobasilar anastomoses
- Persistent primitive trigeminal artery
- Persistent trigeminal artery
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- Pontine haemorrhage with hypertensive microangiopathy and persistent trigeminal artery
- Persistent primitive trigeminal artery
- Persistent trigeminal artery
- Persistent primitive trigeminal artery- Saltzman type I
- Persistent primitive trigeminal artery- Saltzman type II
- Aneurysm of the persistent trigeminal artery
- Persistent trigeminal artery
- Persistent trigeminal artery
- Persistent trigeminal artery
- Persistent primitive trigeminal artery (Saltzman I)
- Persistent trigeminal artery
- Persistent trigeminal artery
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