Persistent trigeminal artery

Case contributed by Abenezer Zinaye
Diagnosis certain


Headache and tinnitus of 1 year duration

Patient Data

Age: 50 years
Gender: Male

An aberrant vessel is seen arising from the cavernous segment of the right ICA and coursing posteriorly to supply the distal basilar artery. The ipsilateral PCoA appears hypoplastic.

Case Discussion

A persistent trigeminal artery (PTA) is the most common variant of the persistent carotid-basilar anastomoses. It is said to occur in 0.1 - 0.2% of people. Two types have been described.

Saltzman type 1 PTA supplies the distal basilar artery, whereas type 2 PTA supplies the superior cerebellar arteries. Our case is a type 1 variant which courses posterolaterally around the sella to supply the distal basilar artery. They may also course posteromedially (60%) through the sella before joining the basilar artery, in which case they need to be specifically mentioned to avoid potential injury during trans-sphenoidal surgery. 

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