Suboccipital Approach for Primitive Trigeminal Artery Obliteration Associated with Cavernous Aneurysm

Horiuchi, Tetsuyoshi; Hara, Yosuke; Sasaki, Tatsuya; Nagashima, Hisashi; Hongo, Kazuhiro

doi:10.1016/j.wneu.2010.06.029

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…[234910121415] Our patient underwent direct surgical intervention because it was not clear which of her aneurysms had ruptured and we thought that both the aneurysms required treatment. The subtemporal approach might be useful to address proximal aneurysms in such situations although in cases such as ours we recommend the lateral suboccipital approach to treat both the aneurysms in a single surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

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Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

Yamamoto

Hasegawa²,

Ohmori³

et al. 2011

Surg Neurol Int

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Background:Primitive trigeminal artery variants (PTAVs) are one of the rare persistent fetal anastomoses between the carotid and vertebrobasilar circulations. They originate from the internal carotid artery and join one of the cerebellar arteries instead of the basilar artery.Case Description:We present an 82-year-old woman with subarachnoid hemorrhage due to a ruptured aneurysm originating at a PTAV. Three-dimensional computed tomography angiogram and cerebral angiography revealed bilateral PTAV and two aneurysms originating at the left PTAV. The proximal and distal aneurysms were saccular and fusiform, respectively. She underwent surgical treatment and her postoperative course was uneventful.Conclusion:Our case demonstrates that extremely rare cerebral aneurysms associated with PTAV can be addressed successfully by surgical intervention.

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Section: Discussionmentioning

confidence: 99%

“…The subtemporal approach might be useful to address proximal aneurysms in such situations although in cases such as ours we recommend the lateral suboccipital approach to treat both the aneurysms in a single surgical procedure. [4]…”

Section: Discussionmentioning

confidence: 99%

Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

Yamamoto

Hasegawa²,

Ohmori³

et al. 2011

Surg Neurol Int

View full text Add to dashboard Cite

show abstract

“…[123456] STA-MCA bypass, especially in patients with moyamoya disease, demands a higher level of technical skill because the recipient arteries are usually small and fragile. Although the success rate for STA-MCA bypass is high, immediate donor occlusion occurs in a small number of patients and anastomosis revision is necessary in such cases.…”

Section: Introductionmentioning

confidence: 99%

Rescue revision techniques for end-to-side anastomosis: Technical note

et al. 2014

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Background:Extracranial-intracranial bypass operation is an essential procedure for cerebrovascular surgeons. Proper procedure of the bypass requires special skills, selected instruments, and training in the microsurgical laboratory. In spite of the high success rate for extracranial-intracranial bypass, a potential pitfall while performing an end-to-side anastomosis is poor blood flow or occlusion at the anastomotic site during surgery. If this happens, revision procedure is necessary.Methods:We introduce our salvage techniques for anastomosis revision with or without recipient artery occlusion.Results:With this method, ischemic complication related to revision procedure minimizes ischemic complications.Conclusions:The present technique is a simple method for anastomosis revision.

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The persistent trigeminal artery: development, imaging anatomy, variants, and associated vascular pathologies

2011

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The persistent trigeminal artery (PTA) is the most common and most cephalad-located embryological anastomosis between the developing carotid artery and vertebrobasilar system to persist into adulthood. As such, it is frequently reported as an incidental finding in computed tomography angiography and magnetic resonance angiography studies. Here, we review the embryology, anatomy, and angiographic imaging findings, including important variants of this commonly encountered cerebrovascular anomaly (reported incidence of PTA/PTA variants ranges from 0.1% to 0.76%). Further, the aim is to present the range of associated arterial anomalies or syndromes, as well as pathologies that are associated with a PTA: aneurysms, trigeminal cavernous fistulas, and trigeminal nerve compression. Besides summarizing the risks and clinical presentation of such pathologies, their management is discussed with endovascular strategies mostly being the primary choice for aneurysms and trigeminal cavernous fistulas. Symptomatic trigeminal nerve compression can be treated with microvascular decompression surgery. As an illustrative example, a case of a trigeminal cavernous fistula on a PTA variant is included, mainly to emphasize the importance of understanding the variant anatomy for treatment planning in such pathologies. Finally, recommendations on how to manage patients with PTA-associated vascular pathologies are advanced.

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Suboccipital Approach for Primitive Trigeminal Artery Obliteration Associated with Cavernous Aneurysm

Cited by 4 publications

References 6 publications

Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

Ruptured cerebral aneurysm associated with a persistent primitive trigeminal artery variant

Rescue revision techniques for end-to-side anastomosis: Technical note

The persistent trigeminal artery: development, imaging anatomy, variants, and associated vascular pathologies

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