Persistent trigeminal artery variant functioning as a duplicate superior cerebellar artery

The cerebral arterial circle displays significant variation, with infrequent configurations often ascertained through contemporary imaging techniques. We present a sporadic case of a duplicated superior cerebellar artery (SCA) discovered during magnetic resonance angiography (MRA) of a 58-year-old female patient. Typical SCA emanates from the distal basilar artery (BA), whereas a duplicate one originates from the pre-cavernous segment of the internal carotid artery (ICA). This accessory vessel traveled parallel to the primary SCA, supplying a portion of its standard vascular territory. This distinctive configuration corresponds to a PTA variant featuring a duplicate SCA, a combination very rarely reported in existing literature. The variant above underscores the embryological origins of the cerebral arterial circle, particularly involving carotid-vertebrobasilar anastomoses. The existence of both a typical and a duplicate SCA constitutes an unprecedented configuration within literature. These vascular anomalies possess clinical significance, especially to neurovascular compression syndromes, such as trigeminal neuralgia, or during surgical and endovascular interventions.