Right persistent trigeminal artery variant (PTAV) and tiny left PTA associated with bilateral ophthalmic arteries arising from the cavernous segments of the internal carotid arteries.

Persistent trigeminal artery (PTA) and its variant (PTAV) are the most prevalent types of carotid-vertebrobasilar anastomosis, but bilateral anastomoses are exceedingly rare. We report a case of a right PTAV and tiny left lateral-type PTA from which the cerebellar artery (presumed anterior inferior cerebellar artery) arose. And also, bilateral ophthalmic arteries arose from the cavernous segments of the internal carotid arteries and entered the orbits via the superior orbital fissures. Selective cerebral angiography, especially 3-dimensional angiography, is superior to magnetic resonance (MR) angiography to identify rare variations of the cerebral arteries. Careful observation of MR angiographic source images is important for identifying unique arterial coursing.