Persistent trigeminal artery causing "double" neurovascular conflict
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Updated: Jun 25, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Angelo Maurizio Clerici1, Paola Merlo, Felice Rognone
1Neurology Unit, Ospedale di Circolo-University of Insubria, Varese, Italy.
Abstract:
We report the case of a 73-year-old woman who presented with right VI nerve palsy and homolateral atypical trigeminal neuralgia; standard neuroradiological investigation of orbital/retroorbital regions and intracranial arteries excluded the most commonly demonstrable underlying causes while brain magnetic resonance (T1-weighted fat suppression; T2-weighted thin-section) and magnetic resonance angiography disclosed the evidence of "double" neurovascular conflict because of persistent trigeminal artery with aneurysmal dilation. A role of this almost rare vascular condition in causing painful ophthalmoplegia is discussed.
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