Persistent Trigeminal Artery Variant: MR Angiographic Demonstration. A Report of Two Cases

Area of Science:

• Vascular anatomy
• Neuroimaging
• Cerebrovascular variants

Background:

• The persistent fetal carotid-vertebral anastomosis (PTAV) represents the persistence after birth of the fetal connection between the internal carotid artery and a cerebellar artery.
• Vascular anomalies of the brain require accurate identification for safe clinical management.

Purpose of the Study:

• To describe two cases of PTAV diagnosed using MR angiography.
• To compare PTAV with the persistent trigeminal artery.
• To explain the extended Saltzman classification for these variants.

Main Methods:

• Case report of two patients with PTAV.
• Magnetic Resonance Angiography (MRA) for visualization.
• Comparison with existing literature and classifications.

Main Results:

• PTAV was successfully demonstrated in two patients via MRA.
• A comparison highlighted similarities and differences with the persistent trigeminal artery.
• The extended Saltzman classification provides a framework for understanding these variants.

Conclusions:

• PTAV, while generally of low clinical significance, necessitates recognition to prevent complications during surgical or interventional procedures.
• Understanding PTAV aids in explaining paradoxical cerebellar lesions.
• Selective angiography is suggested to be superior to MRA for diagnosing PTAV.