Persistent Trigeminal Artery: An Anatomic Study

Persistent Trigeminal Artery: An Anatomic Study AbstractINTRODUCTION:The most frequent embryonic communication between the vertebrobasilar and carotid systems is a persistent trigeminal artery (PTA). It has been observed in 0.1 to 0.2% of cerebral angiograms. We found this variation in an anatomic specimen, and after microscopic dissection, we performed an analysis of the course of the PTA and its relationship with the abducens nerve and the meningohypophyseal trunk.METHODS:A PTA was incidentally encountered in an injected cadaver specimen during a transpetrosal approach. This embryonic variation and its anatomic relationship are discussedRESULTS:The PTA can take either a lateral or medial course regarding its relationship with the abducens nerve. When the PTA originates from the posterolateral aspect of the posterior bend of the cavernous carotid artery (C4 segment), it crosses underneath and distorts the abducens nerve, continuing between the abducens and trigeminal nerves. When taking a medial course, the PTA arises from the posteromedial aspect of the posterior bend of the cavernous carotid at the same segment and pierces the clival dura at the dorsum sellae. Cranial nerve displacement or distortion is less likely in this variation. In an analysis of carefully described anatomic studies, the PTA and meningohypophyseal trunk were found arising from either common or separated origins.CONCLUSION:The most frequent embryological anastomosis between the carotid and vertebrobasilar system is the PTA. Its course and relationship with the cranial nerves may determine its clinical presentation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Persistent Trigeminal Artery: An Anatomic Study

Persistent Trigeminal Artery: An Anatomic Study

A N A T O M IC REPO RTS Eduardo Salas, M.D., Ibrahim M. Ziyal, M.D., Laligam N. Sekhar, M.D., Donald C. Wright, M.D. Department of Neurological Surgery, The George Washington University Medical Center, Washington, District of Columbia INTRODUCTION: The most frequent embryonic communication between the vertebrobasilar and carotid systems is a persistent trigeminal artery (PTA). It has been observed in 0.1 to 0.2% of cerebral angiograms. We found this variation in an anatomic specimen, and after microscopic dissection, we performed an analysis of the course of the PTA and its relationship with the abducens nerve and the meningohypophyseal trunk. METHOD: A PTA was incidentally encountered in an injected cadaver specimen during a transpetrosal approach. This embryonic variation and its anatomic relationship are discussed. RESULTS: The PTA can take either a lateral or medial course regarding its relationship with the abducens nerve. When the PTA originates from the posterolateral aspect of the posterior bend of the cavernous carotid artery (C4 segment), it crosses underneath and distorts the abducens nerve, continuing between the abducens and trigem­ inal nerves. When taking a medial course, the PTA arises from the posteromedial aspect of the posterior bend of the cavernous carotid at the same segment and pierces the clival dura at the dorsum sellae. Cranial nerve displacement or distortion is less likely in this variation. In an analysis of carefully described anatomic studies, the PTA and meningohypophyseal trunk were found arising from either common or separated origins. CONCLUSION: The most frequent embryological anastomosis between the carotid and vertebrobasilar system is the PTA. Its course and relationship with the cranial nerves may determine its clinical presentation. (Neurosurgery 4 3 : 5 5 7 - 5 6 2 , 1 9 9 8 ) Keywords: Abducens nerve, Cavernous sinus, Persistent trigeminal artery A N A TO M IC D ESC R IP TIO N our persistent embryonic communicating...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199809000-00082
Publisher site
See Article on Publisher Site

Abstract

AbstractINTRODUCTION:The most frequent embryonic communication between the vertebrobasilar and carotid systems is a persistent trigeminal artery (PTA). It has been observed in 0.1 to 0.2% of cerebral angiograms. We found this variation in an anatomic specimen, and after microscopic dissection, we performed an analysis of the course of the PTA and its relationship with the abducens nerve and the meningohypophyseal trunk.METHODS:A PTA was incidentally encountered in an injected cadaver specimen during a transpetrosal approach. This embryonic variation and its anatomic relationship are discussedRESULTS:The PTA can take either a lateral or medial course regarding its relationship with the abducens nerve. When the PTA originates from the posterolateral aspect of the posterior bend of the cavernous carotid artery (C4 segment), it crosses underneath and distorts the abducens nerve, continuing between the abducens and trigeminal nerves. When taking a medial course, the PTA arises from the posteromedial aspect of the posterior bend of the cavernous carotid at the same segment and pierces the clival dura at the dorsum sellae. Cranial nerve displacement or distortion is less likely in this variation. In an analysis of carefully described anatomic studies, the PTA and meningohypophyseal trunk were found arising from either common or separated origins.CONCLUSION:The most frequent embryological anastomosis between the carotid and vertebrobasilar system is the PTA. Its course and relationship with the cranial nerves may determine its clinical presentation.

Journal

NeurosurgeryOxford University Press

Published: Sep 1, 1998

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