Primitive Trigeminal Artery Variant Aneurysm Treated With Guglielmi Detachable Coils. Case Report.

Abstract

A 69-year-old woman had suffered from diplopia on right lateral gaze for the last 4 months due to right abducens nerve paresis. Right carotid angiography showed a cavernous internal carotid artery (ICA) aneurysm of 17 × 16 × 14 mm size and a primitive trigeminal artery (PTA) variant supplying the territory of the posterior inferior cerebellar artery. Intraluminal occlusion of the aneurysm was performed with 15 Guglielmi detachable coils. The flow of the PTA variant and the ICA was preserved. Right abducens nerve paresis improved partially. PTA variant is a primitive artery originating from the cavernous ICA supplying the cerebellum without opacification of the basilar artery. Only four of the 67 cases of PTA variant were associated with an aneurysm of the PTA variant. The possibility of this rare association should be considered when treating cavernous portion aneurysm because of the risk of cerebellar ischemia.

Double-Balloon Remodeling for Coil Embolization of a Primitive Trigeminal Artery Variant Aneurysm

“…Two cases were surgically clipped 12,15 , two were treated by coil embolization 13,14 , and two underwent parent artery occlusions 11,16 . The PTA and PTA variants are located deep and close to the cranial nerve and perforating vessels, making the surgical approach very difficult.…”

Persistent primitive trigeminal artery as a cause of trigeminal neuralgia and persistent primitive trigeminal artery associated with pituitary adenoma: Two case reports

“…PPTA is usually reported to be detected incidentally and is shown to be rarely associated with pituitary lesions, vascular anomalies, trigeminal neuralgia and aneurysms [3,4]. Four cases of functional macro-adenoma and one case of non-functional adenoma accompanying PPTA have been reported in the literature [6][7][8][9].…”

A Rare Variant of Persistent Trigeminal Artery: Cavernous Carotid-Cerebellar Artery Anastomosis—A Case Report and a Systematic Review

“…The most common radiographic manifestation of primitive carotid-basilar anastomosis is filling of the basilar and its branches from a carotid injection [6]. Persistent trigeminal artery variant ending in the cerebellar arteries without an interposed segment of the basilar artery was scarcely described in the literature [9].…”