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Persistent Trigeminal Artery Causing an Abducens Nerve Palsy: A Case Report
Aimee Lloyd1,2, Sunila Jain1, Diana Duke1
1Department of Ophthalmology, Lancashire Teaching Hospitals NHS Trust, Preston, UK.
Neuro-Ophthalmology (Aeolus Press)
|February 17, 2023
Summary
A persistent trigeminal artery (PTA), a rare vascular anomaly, can compress cranial nerves. This case highlights PTA as a cause of isolated abducens nerve palsy, presenting with double vision.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroanatomy
Background:
- Persistent trigeminal artery (PTA) is the most common remnant of fetal circulation between carotid and vertebrobasilar systems.
- PTA occurs in 0.1–0.6% of cerebral angiograms and is often an incidental finding.
- PTA is associated with vascular abnormalities like aneurysms and cranial nerve compression.
Observation:
- A 50-year-old female presented with isolated right abducens nerve palsy, causing diplopia.
- Magnetic resonance imaging (MRI) revealed a right-sided PTA.
- The PTA was observed indenting the ventral pons.
Findings:
- The patient's abducens nerve palsy was attributed to neurovascular compression by the PTA.
- This case demonstrates a direct link between PTA and isolated abducens nerve palsy.
Implications:
- Neurovascular compression by PTA should be considered in cases of isolated abducens nerve palsy.
- Further research is needed to evaluate the efficacy of surgical interventions for non-aneurysmal PTA.
Keywords:
Abducens nerve palsydiplopianeurovascular compressionpersistent trigeminal arterysixth nerve palsy
