A case of persistent carotid-basilar anastomosis associated with aneurysm of the homolateral middle cerebral artery manifested by oculomotor palsy

Persistent trigeminal artery: in situ thrombosis and associated perforating vessel infarction

We report a patient with progressive brainstem infarction despite medical therapy. The patient was transferred to our institution for potential angioplasty of basilar stenosis. Imaging review demonstrated persistent trigeminal artery in situ thrombosis and associated perforating vessel infarction. Persistent trigeminal arteries are commonly associated with an atretic basilar artery and interventional treatment can result in significant morbidity and mortality.

Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance

As fetal intracranial vessels may persist into adulthood, knowledge of their anatomy and potential clinical and surgical complications should be borne in mind by the surgeon. A comprehensive review of these vessels, however, is not easily identified in the literature. Therefore, the present analysis was undertaken so that such information is available to the clinician and morphologist.

Cadaveric findings of persistent fetal trigeminal arteries

Persistence of fetal intracranial arteries is rare. We review this anatomical literature regarding the persistence of the trigeminal artery and discuss the findings in two cadaveric cases both found to harbor this vessel. This anomaly should be considered by the clinician and anatomist who view imaging of the skull base. Additionally, the relationships between such an artery and other structures within the cavernous sinus should be understood by the neurosurgeon who operates in this region, e.g., transsphenoidal approaches to the skull base.

Branches of the petrous and cavernous segments of the internal carotid artery

Microsurgical approaches to the skull base require a thorough knowledge of the microvasculature of this region. Interestingly, most standard texts of anatomy do not mention the branches of the internal carotid artery as it travels through the temporal bone and cavernous sinus. Although small and with often conflicting descriptions, these arterial branches may be of significance when contributing to the vascular supply of such pathological entities as meningiomas and vascular malformations. Furthermore, multiple anastomoses exist between these branches and branches of the external carotid artery, thus providing a potentially important collateral circulation between these two systems and thus retrograde flow needed to maintain the patency of the distal internal carotid artery (ICA) when this vessel is obstructed proximally. We review the literature regarding these branches of the internal carotid artery and their clinical significance.

Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature

The persistence of embryonic carotid-basilar and carotid-vertebral anastomoses was investigated retrospectively in 4,400 cerebral angiograms. Six primitive persistent carotid-basilar anastomoses and one primitive persistent carotid-vertebral anastomosis were found. In 4,400 cerebral angiograms, the incidence of primitive carotid-basilar and carotid-vertebral anastomoses was 0.14% and 0.023% respectively. Primitive persistent anastomoses are associated with intracranial vascular anomalies, especially aneurysms. The clinical and pathological findings in combination with these primitive persistent anastomoses were also examined.

Vascular anomalies and subarachnoid haemorrhage associated with persisting embryonic vessels

In 25 per cent of patients with persistinc primitive trigeminal artery, and in 27 percent of patients with primitive hypoglossal artery, vascular malformations or a history of subarachnoid haemorrhage were found. There is a high incidence of aneurysms at the site of origin of the persisting embryonic vessels. No relation was found between the persisting embryonic vessels and the age, sex, and time of subarachnoid haemorrhage. Opacification of posterior cerebral arteris, vertebral arteries, and posterior communicating arteries was analysed, and variations of the Circulus arteriosus Willisi were found. Ten patients with persisting embryonic vessels are described. In patients in whom external carotid-middle cerebral artery bypass is planned, attention should be drawn to the possibility of persisting embryonic vessels.

Bilateral cortical blindness associated with carotid stenosis in a patient with a persistent trigeminal artery: case report

A patient with findings of bilateral cortical blindness and a unilateral carotid bruit is reported. A persistent trigeminal artery allowed emboli from a unilateral ulcerated internal carotid plaque to affect the visual cortex bilaterally. The angiographic findings and a brief discussion of this anomalous artery are presented.

Operative approach to persistent trigeminal artery producing facial pain and diplopia. Case report

A case is reported of persistent trigeminal artery producing intermittent facial pain, the last episode being associated with diplopia. The trigeminal and abducent nerves were attached to the trigeminal artery by a congenital membrane. Blood supply to the vertebrobasilar system was via the persistent vessel. A new operative approach along the petrous-temporal ridge is described.

Persistência da artéria hipoglossa primitiva

É relatado o terceiro caso registrado na literatura de diagnóstico em vida de persistência da artéria hipoglossa primitiva, sendo o achado casual, feito durante exploração angiográfica em paciente de 42 anos de idade que sofrerá traumatismo crânio-encefálico. É referida a possibilidade de existência de outros vasos anômalos, assim como da concomitância de tais anomalias com malformações vasculares e aneurismas.

[Carotid-basilar anastomosis]

O autor relata um caso de anastomose carótido-basilar por persistência da artéria trigeminal, demonstrado angiogràficamente. O paciente apresentou hemiplegia súbita e era portador de transtornos mentais de tipo deficitário. A pneumencefalografia evidenciou atrofia do parênquima cerebral do lado da anomalia.

[Persistence of carotid-basilar anastomosis; case revealed by cerebral angiography]

Publicando êste caso, o autor eleva para 23 o total dos casos registrados de persistência da anastomose carótido-basilar. Trata-se de caso cujo paciente foi submetido a estudo angiográfico injetando o contraste sucessivamente em ambas as artérias carótidas e no sistema vértebro-basilar. Êste é o sétimo caso com demonstração angiográfica da persistência da comunicação entre a carótida e a basilar. A presença desta anomalia condiciona modificações na hemodinâmica intracraniana demonstradas neste caso.