Persistent trigeminal artery linked with partial duplication of the anterior communicating artery

Variations of the cerebral arterial circle are frequently observed due to the progressively increasing utilization of diagnostic imaging techniques. Among these variations, the persistence of embryonic vessels, such as the persistent trigeminal artery (PTA), is rare yet holds significant clinical relevance. This presentation details a distinctive case of the PTA coexisting with a partial duplication of the anterior communicating artery (AComA), as identified through magnetic resonance angiography (MRA) in a 41-year-old female patient. The PTA was documented as a vessel linking the basilar artery to the cavernous segment of the left internal carotid artery. The AComA exhibited two branches emanating from the left anterior cerebral artery (LACA), which fused to form a single vessel that anastomosed with the right anterior cerebral artery (RACA). The coexistence of the PTA and AComA variant accentuates the imperative for clinicians to consider such rare anatomical configurations, mainly when performing procedures in proximity to the gasserian ganglion, cavernous sinus, or anterior circulation. The application of three-dimensional imaging remains vital for ensuring precise diagnosis and effective treatment planning.