Bilateral persistent primitive trigeminal arteries associated with trigeminal neuralgia

Area of Science:

• Neuroanatomy
• Vascular Neurology
• Developmental Biology

Background:

• Persistent carotid-vertebrobasilar anastomoses (PCVBA) are rare congenital vascular anomalies.
• The primitive trigeminal artery (PTA) is the most common type of PCVBA, connecting the internal carotid artery (ICA) to the basilar artery (BA).

Observation:

• A rare case involving bilateral PTAs, a unilateral PTA variant (PTAV), and trigeminal neuralgia is detailed.
• This case also presented with the absence of the proximal basilar artery and bilateral absence of the distal vertebral arteries.

Findings:

• The presented anomalies, including bilateral PTAs and absent distal vertebral arteries, are consistent with developmental variations of the vertebrobasilar junction.
• The co-occurrence of these anomalies suggests a shared congenital etiology.

Implications:

• Understanding these rare vascular variants is crucial for accurate diagnosis and management of neurological symptoms like trigeminal neuralgia.
• This case contributes to the understanding of the embryological development of the vertebrobasilar system and its potential anomalies.