Related Experiment Video
Updated: Jan 6, 2026
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Persistent Trigeminal Artery Playing a Protective Role in a Case of Vertebral Artery Dissection and Stenosis
Michelle Nunes1, Aqsa Ullah1, Joseph Rios1
1Neurology, University of Central Florida/Osceola Regional Medical Center, Orlando, USA.
Insights
Persistent trigeminal artery (PTA) can protect the brainstem during vertebral artery dissection. This rare fetal anastomosis provided crucial collateral blood flow, preventing a more severe outcome in a medullary stroke case.
Area of Science:
- Neuroscience
- Vascular Neurology
- Embryology
Background:
- Fetal anastomoses between carotid and vertebrobasilar circulations typically regress during development.
- Persistence of the primitive trigeminal artery (PPTA) is the most common persistent fetal anastomosis, though rarely identified in adults.
Observation:
- A 31-year-old female experienced a medullary stroke secondary to vertebral artery dissection.
- Imaging revealed a persistent trigeminal artery (PTA).
Findings:
- The PTA provided significant collateral blood flow from the internal carotid artery (ICA) to the brainstem.
- This robust collateral circulation via the PTA potentially mitigated the ischemic damage from the vertebral artery dissection.
Implications:
- Knowledge of PPTA is crucial for interpreting cranial imaging in clinical practice.
- While often associated with pathologies like aneurysms, PPTA may have a protective role in specific cerebrovascular events.
- This case highlights the potential beneficial function of persistent fetal cerebrovascular channels.
Abstract:
Several fetal anastomoses have been described between the carotid and vertebrobasilar circulations. These anastomoses usually revert while the P1 segment (posterior cerebral artery segment 1) develops. However, these primitive intracranial embryonic anastomes can occasionally persist in adult age. Persistence of the primitive trigeminal artery (PPTA) is the most common of these persistent fetal anastomoses. Although uncommonly identified, knowledge of this structure is crucial for clinicians who analyze cranial imaging. PPTA has been associated with intracranial aneurysms and arteriovenous malformations but it is not very clear whether or not PPTA can also play a protective role in certain cases. We present the case of a 31-year-old female who suffered from a medullary stroke due to vertebral artery dissection and the persistent trigeminal artery (PTA) possibly played an important protective role since blood flow to the brainstem was preserved via a robust collateral flow from the right internal carotid artery (ICA).
Related Concept Videos
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:10The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies