Luis Alberto Rodriguez-Hernandez1, Pablo Martinez2, Iván Baracaldo2, Monica Alonso3, Diego Lopez-Mena2, Héctor Alfredo Montenegro Rosales4. 1. Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. 2. Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. 3. Department of Neurology, Universidad del Sinu, Cordoba, Colombia. 4. Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico. dr.montenegrorx@gmail.com.
Abstract
BACKGROUND: Persistent trigeminal artery or persistent primitive trigeminal artery (PTA) is the most common carotid-basilar anastomosis in both cadaveric and live patient studies, followed by persistent hypoglossal and persistent otic arteries. Approximately 0.2% of all angiographies reported this finding. CASE REPORT: We present the case of a 21-year-old male who arrived at the emergency department with tonic‒clonic seizures. After performing diagnostic contrast magnetic resonance imaging and digital subtraction angiography, the patient was diagnosed with a right occipital arteriovenous malformations (AVM) fed by the right calcarine artery associated with an ipsilateral PTA. After considering surgical and endovascular treatment options, the patient was selected for watchful waiting. We included a literature review of the PTA, the results of a PubMed search regarding the combined presence of these findings, and a brief discussion providing insight into the implications for treatment. CONCLUSIONS: Although several studies have linked PTA to different vascular pathologies, such as cerebral aneurysms, the association between PTA and AVMs remains scarce. This case, along with the literature review, shows that further research is needed to characterize the relationship between these findings.
BACKGROUND: Persistent trigeminal artery or persistent primitive trigeminal artery (PTA) is the most common carotid-basilar anastomosis in both cadaveric and live patient studies, followed by persistent hypoglossal and persistent otic arteries. Approximately 0.2% of all angiographies reported this finding. CASE REPORT: We present the case of a 21-year-old male who arrived at the emergency department with tonic‒clonic seizures. After performing diagnostic contrast magnetic resonance imaging and digital subtraction angiography, the patient was diagnosed with a right occipital arteriovenous malformations (AVM) fed by the right calcarine artery associated with an ipsilateral PTA. After considering surgical and endovascular treatment options, the patient was selected for watchful waiting. We included a literature review of the PTA, the results of a PubMed search regarding the combined presence of these findings, and a brief discussion providing insight into the implications for treatment. CONCLUSIONS: Although several studies have linked PTA to different vascular pathologies, such as cerebral aneurysms, the association between PTA and AVMs remains scarce. This case, along with the literature review, shows that further research is needed to characterize the relationship between these findings.
Authors: Omar Choudhri; Jeremy J Heit; Abdullah H Feroze; Steven D Chang; Robert L Dodd; Gary K Steinberg Journal: J Clin Neurosci Date: 2014-07-25 Impact factor: 1.961