Persistent trigeminal artery: angio-tomography and angio-magnetic resonance finding

Pereira, L.; Nepomuceno, Lara A.M.; Coimbra, Pablo Picasso; Neto, Sabino Rodrigues de Oliveira; Natal, Marcelo Ricardo Canuto

doi:10.1590/s0004-282x2009000500019

Cited by 10 publications

(9 citation statements)

References 6 publications

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“…The PTA can then be easily identified by MR angiography. Thus, angiography MRI or three-dimensional angiography-CT, which is less invasive than traditional angiography, should be performed preoperatively to avoid complications during surgery in suspected cases (11,(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Machado

Kodaira

Musolino

2014

Arq Bras Endocrinol Metab

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SUMMARYPersistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas. Arq Bras Endocrinol Metab. 2014;58(6):661-5 SUMÁRIO Persistência da artéria trigeminal (PAT) é a comunicação embrionária mais frequente entre os sistemas carotídeo e vertebrobasilar. No entanto, alterações hormonais ou associação de PAT com outras lesões selares, como adenomas hipofisários, são extremamente raros. O objetivo do presente estudo foi relatar dois pacientes com PAT intrasselar e concomitante adenoma hipofisário e enfatizar a importância para o diagnóstico diferencial de lesões selares. Caso 1. Paciente do sexo feminino, 41 anos, admitida com história de cefaleia crônica (> 20 anos). Ressonância magnética (RM) de hipófise mostrou imagem arredondada na porção esquerda da glândula sugestiva de adenoma (provavelmente adenoma clinicamente não funcionante). Adicionalmente, a RM demonstrou ectasia da artéria carótida interna direita e imagem sugestiva de artéria intrasselar, posteriormente confirmada por angio-RM dos vasos cerebrais como PAT. Caso 2. Paciente do sexo feminino, 42 anos, admitida com história de amenorreia e galactorreia em 1994. A investigação laboratorial revelou hiperprolactinemia. RM de hipófise mostrou pequena área de hipossinal na porção anterior da glândula sugestiva de microadenoma, sendo iniciad...

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Section: Discussionmentioning

confidence: 99%

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Machado

Kodaira

Musolino

2014

Arq Bras Endocrinol Metab

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“…It is well known that persistence of the fetal circulation results in a higher rate of aneurysm formation 13 19 20. This is felt to be the result of increased flow dynamics and stress at weak points in the vessel wall 20.…”

Section: Discussionmentioning

confidence: 99%

Congenital absence of the common carotid artery in a patient with a ruptured anterior communicating artery aneurysm

Drazin

Choulakian

Alexander

2010

J NeuroIntervent Surg

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In a 41-year-old woman with a ruptured anterior communicating artery aneurysm, cerebral angiography incidentally showed an absence of the right common carotid artery. The right internal and external carotid artery originated from the ipsilateral inominate artery. The absence of the common carotid artery is extremely rare and association with a ruptured cerebral aneurysm is even less common. A description of the case and review of the literature are reported.

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“…[1] Its termination may be in one of 3 ways -anastamosing with the basilar artery below the superior cerebellar artery and supplying both posterior cerebral and superior cerebellar arteries (Saltzman Type 1), anastamosing with the basilar artery below the superior cerebellar artery but supplying only both superior cerebellar arteries and one or both posterior cerebral arteries being supplied by the posterior communicating arteries (Saltzman Type 2) or it may end in one of the cerebellar arteries (Saltzman Type 3). [1][2][3][4] Our case was one of Saltzman Type 1. The "Tau (τ)" sign is a classic angiographic sign of a persistent trigeminal artery.…”

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confidence: 80%

“…Usually diagnosed incidentally, [1,2] it may rarely cause cranial neuropathies (like trigeminal neuralgia) [3] and this anomaly must be kept in mind during any surgeries involving this area to prevent iatrogenic injury. [3,4] …”

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confidence: 99%

Angiographic "Tau (τ)" sign in persistent trigeminal artery

et al. 2014

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Brain magnetic resonance imaging (MRI) of a 44-year-old lady done as part of the evaluation of non-specific headache, revealed a left side vascular anomaly. Neurologic examination was normal. MR-angiogram with Time Of Flight (TOF) sequence showed a persistent trigeminal artery on the left side extending backwards by the side of the sella from the internal carotid artery to the basilar artery [ Figure 1]. Coronal T2 and reconstructedimages showed that the artery was joining the basilar trunk below the origin of the superior cerebellar artery [ Figure 2]. The vertebrobasilar complex below the union was hypoplastic. Sagittal reconstructions showed that both posterior communicating arteries were absent and "tau" sign was present at the site of origin of the vessel from the internal carotid artery [ Figure 3].

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Persistent trigeminal artery: angio-tomography and angio-magnetic resonance finding

Cited by 10 publications

References 6 publications

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Congenital absence of the common carotid artery in a patient with a ruptured anterior communicating artery aneurysm

Angiographic "Tau (τ)" sign in persistent trigeminal artery

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