Learning objectives
To detect the Persistent Trigeminal Artery(PTA), its course,
and the main vascular anomalies associeted with,
through angio-Tc and angio-MR studies.
Background
Persistent trigeminal artery is the most common fetal anastomotic artery,
found in adulthood.
It persists for the longest embryonic period (untilthe 11 mm to 14 mm embryonic stage),
in wich a dynamic process of the developing brain continually reshapes the vessels by formation,
regression and anastomosis which are leading by momentary emodinamic needs (Fig.1).
The involution of PTA is also guaranteed by the fusion of the two neural arteries into the basilar trunk (BA); whenthe BA doesn’t totally developed,
we could assist at its hypoplasia,...
Findings and procedure details
The PTA originates indifferently from left or right ICA,Saltzman in 1959 proposed an angiographic classification into main types (Fig 2.):
Type 1 with insertion on the BA,
proximally to the SCA;
Type 2with insertion on the BA,
at the emergency of the SCA;
Type 3 (other variants),
with insertion on the SCA,
AICA or PICA,
without anastomosis with the BA.
In the last years,
thanks to the use of the available technologies,
it is possible to easy identify the persiostence of trigeminal artery,
with angio...
Conclusion
Through angio-CT/RM studies and appropriate reconstructions (MPR,
MIP and VR),
the radiologist is able to recognize the presence of PTA,
to evaluate its anatomy and course,
to decte the anomalies associated with it,
providing a valid support for clinics and for the endovascular management of the interventional and neurosurgical radiologist.
Personal information
Department of Radiology, AOUP Palermo,
University of Palermo,
Italy:
F.Incandela MD:
Radiology- Interventional Radiology Resident
e-mail:
[email protected]
D.G.Castiglione MD:
Radiology-Interventional Radiology Resident
e-mail:
[email protected]
I.
Di Gesù MD:
Interventional Radiologist
e-mail:
[email protected]
Professor T.V.Bartolotta MD-PA-PhD:
Radiologist
e-mail:
[email protected]
Professor M.Midiri Director:
Radiologist
e-mail:
[email protected]
M.A.
Banco MD:
Neuroradiologist
email:
[email protected]
References
Fields WS: The significance of persistent trigeminal artery.
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Suttner N,
Mura J,
Tedeschi H,
Ferreira M,
Wen H,
de Oliveira E,
Rhoton AL Jr: Persistent trigeminal artery: A unique anatomic specimen- analysis and therapeutic implications.
Neurosurgery 47:428-434,
2000;
Waleed A,
Johnny D,
Mohammed M: Persistent Primitive Trigeminal Artery: A Review. Turkish Neurosurgery 4:399-406,2012;
Cloft HJ,
Razack N,
Kallmes DF: Prevalence of cerebral aneurysms in patients with persistent primitive trigeminal artery.
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Neurosurg 90:865– 867,
1999;
Padget DH: Development of cranial arteries in human...