Transcranial sonography in a patient with a persistent trigeminal artery

Area of Science:

• Neuroimaging
• Vascular Neurology
• Cerebrovascular Physiology

Background:

• Persistent trigeminal artery (PTA) is a rare remnant of fetal circulation connecting the internal carotid artery to the vertebrobasilar system.
• Understanding PTA hemodynamics is crucial for diagnosing potential cerebrovascular events.
• Transcranial ultrasonography (TCS) offers a non-invasive method to assess intracranial blood flow.

Observation:

• Transcranial ultrasonography was employed in a patient diagnosed with a persistent trigeminal artery.
• The examination focused on evaluating blood flow dynamics within the connected vascular territories.
• Specific attention was given to the flow characteristics of the vertebral and basilar arteries.

Findings:

• The study identified significantly low blood flow velocity in the vertebral artery.
• A reversal of blood flow direction was observed in the basilar artery.
• These hemodynamic alterations are directly linked to the presence and anatomical configuration of the persistent trigeminal artery.

Implications:

• The findings highlight the potential for altered cerebral perfusion due to persistent trigeminal artery.
• This case underscores the utility of transcranial ultrasonography in characterizing complex cerebrovascular anatomy and flow.
• Further research is warranted to elucidate the long-term clinical significance and management strategies for patients with persistent trigeminal artery and associated flow abnormalities.