Trigeminal Neuralgia Associated with a Primitive Trigeminal Artery Variant: Case Report

Tamura, Yoji; Shimano, Hiroshi; Kuroiwa, Toshihiko; Miki, Yoshihito

doi:10.1227/01.neu.0000058023.55777.44

Cited by 23 publications

(12 citation statements)

References 10 publications

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“…There are two types of PPTA: one courses medially to the basilar artery as shown in the present case, and the other, called a PPTA variant, courses laterally and directly into the cerebellar cortical artery (3)(4)(5)(6)(7). The first type of PPTA does not tend to compress the REZ of the trigeminal nerve (6,7).…”

supporting

confidence: 50%

“…A PPTA is an infrequent, anomalous vessel; trigeminal neuralgia associated with this vessel is uncommon (9)(10)(11)(12). The incidence of trigeminal neuralgia caused by PPTA has been previously reported to range from 0.1% to 2.2% (4,6,7,9,10). It is known that PPTA is found with various vascular anomalies on radiological examinations including agenesis of the internal carotid artery, AVM and aneurysms, and trigeminal neuralgia (10,12,13).…”

Section: Discussionmentioning

confidence: 99%

“…It is extremely rare that a PPTA or a PPTA variant compresses the trigeminal nerve. According to previous reports, these vessels were observed in only 0.2% to 0.6% of patients with trigeminal neuralgia (3)(4)(5). Some PPTAs are likely to compress the REZ, causing trigeminal neuralgia.…”

mentioning

confidence: 84%

“…A PPTA may be associated with vascular anomalies such as aneurysms or arteriovenous malformations (AVMs). It may also be associated with trigeminal neuralgia (3)(4)(5)(6)(7)(8)(9).…”

mentioning

confidence: 99%

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Identification of a Persistent Primitive Trigeminal Artery Following the Transposition Technique for Trigeminal Neuralgia: A Case Report

Kato

Tanaka

Sakamoto

et al. 2011

Pain Research and Management

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A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel's cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient's symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve.

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supporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 84%

“…A PPTA may be associated with vascular anomalies such as aneurysms or arteriovenous malformations (AVMs). It may also be associated with trigeminal neuralgia (3)(4)(5)(6)(7)(8)(9).…”

mentioning

confidence: 99%

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Identification of a Persistent Primitive Trigeminal Artery Following the Transposition Technique for Trigeminal Neuralgia: A Case Report

Kato

Tanaka

Sakamoto

et al. 2011

Pain Research and Management

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“…6) Compression of the trigeminal nerve by the PTA or PTA variant is the cause of 0.2% to 0.6% of cases of trigeminal neuralgia (TN). [2][3][4][5]11) We treated a 31-year-old man with typical TN caused by an anomalous artery which directly originated from the PTA and then coursed to the territory of the anterior inferior cerebellar artery (AICA).…”

Section: Introductionmentioning

confidence: 99%

Trigeminal Neuralgia Associated With an Anomalous Artery Originating From the Persistent Primitive Trigeminal Artery

Yamada

Kondo

Tanabe

2006

Neurol. Med. Chir.(Tokyo)

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Fig. 1 Magnetic resonance angiograms, axial view(A) and lateral view (B), revealing the primitive trigeminal artery (PTA) (arrow) originating from the posterolateral aspect of the left internal carotid artery and connecting with the basilar artery, and also an anomalous small artery (arrowhead) directly originating from the PTA. 194Neurol Med Chir (Tokyo) 46, 194¿197, 2006 AbstractA 31-year-old man presented with typical trigeminal neuralgia caused by an anomalous variant type of anterior inferior cerebellar artery (AICA) directly branching from the primitive trigeminal artery (PTA). Three-dimensional computed tomography angiography, magnetic resonance angiography, and magnetic resonance cisternography disclosed that this anomalous artery originated from the PTA and coursed to the AICA territory of the cerebellum. Microvascular decompression surgery disclosed the trigeminal nerve compressed by this AICA variant together with the superior cerebellar artery. These arteries were successfully transpositioned to decompress the nerve. Careful and thorough inspection around the trigeminal nerve verified that the PTA did not conflict with the nerve. This unusual case was caused by compression of the trigeminal nerve from the AICA directly originating from the PTA, without the more common involvement of the PTA.

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Persistent Carotid-Basilar and Carotid-Vertebral Anastomoses

McKinney

2017

Atlas of Normal Imaging Variations of the Brain, Skull, and Craniocervical Vasculature

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Trigeminal Neuralgia Associated with a Primitive Trigeminal Artery Variant: Case Report

Cited by 23 publications

References 10 publications

Identification of a Persistent Primitive Trigeminal Artery Following the Transposition Technique for Trigeminal Neuralgia: A Case Report

Identification of a Persistent Primitive Trigeminal Artery Following the Transposition Technique for Trigeminal Neuralgia: A Case Report

Trigeminal Neuralgia Associated With an Anomalous Artery Originating From the Persistent Primitive Trigeminal Artery

Persistent Carotid-Basilar and Carotid-Vertebral Anastomoses

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