Korean J Radiol.  2009 Oct;10(5):519-522. 10.3348/kjr.2009.10.5.519.

Giant Cavernous Aneurysm Associated with a Persistent Trigeminal Artery and Persistent Otic Artery

Affiliations
  • 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China.
  • 2Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China. xiaodong_1962@163.com

Abstract

Primitive trigeminal artery (PTA) and primitive otic artery (POA) is a very rare entity in adult life. We present a case of PTA and POA associated with a giant unruptured cavernous aneurysm in a 54-year-old woman. The PTA and the POA arose from the sac of the aneurysm directly, which greatly complicated endovascular therapy management.

Keyword

Aneurysm; Persistent trigeminal artery; Persistent otic artery

MeSH Terms

*Cerebral Angiography
Cerebral Arteries/*abnormalities
Diagnosis, Differential
Embolization, Therapeutic
Female
Humans
Intracranial Aneurysm/*radiography/therapy
Middle Aged

Figure

  • Fig. 1 Giant cavernous aneurysm with persistent trigeminal and otic arteries in 54-year-old woman. A. Lateral image of right internal carotid artery shows giant cavernous sinus aneurysm and persistent primitive trigeminal artery (arrow). B. Three-dimensional rotational angiographic reconstructions of right internal carotid artery demonstrate persistent trigeminal artery, which arose from aneurysm sac, near normal origin of meningohypophyseal trunk (arrows). C. Before balloon occlusion test, primitive trigeminal artery is not shown in lateral image of left vertebral and basilar artery. D. After balloon occlusion test, left vertebral artery angiogram demonstrated primitive trigeminal artery (arrow). Note indefinite persistent otic artery. E. After balloon occlusion test, lateral image of right vertebral artery revealed primitive trigeminal artery (arrow). In addition, note small size of posterior communicating artery, distal end of right internal carotid artery, as well as right anterior and middle cerebral artery. F. After embolization of primitive trigeminal artery with detachable coils: anteroposterior image of left vertebral artery revealed evident persistent otic artery (arrow).


Reference

1. Yilmaz E, Ilgit E, Taner D. Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat. 1995. 8:36–43.
2. Caldemeyer KS, Carrico JB, Mathews VP. The radiology and embryology of anomalous arteries of the head and neck. AJR Am J Roentgenol. 1998. 170:197–203.
3. Ahmad I, Tominaga T, Suzuki M, Ogawa A, Yoshimoto T. Primitive trigeminal artery associated with cavernous aneurysm: case report. Surg Neurol. 1994. 41:75–79.
4. Lie AA. Congenital anomalies of the carotid arteries. 1968. Amsterdam: Excerpta Medica Foundation;70–75.
5. Anderson RA, Sondheimer FK. Rare carotid-vertebrobasilar anastomoses with notes on the differentiation between proatlantal and hypoglossal arteries. Neuroradiology. 1976. 11:113–118.
6. Nonaka Y, Nakatani K, Tanigawara T, Hattori T, Ohkuma A, Kaku Y, et al. A case of a persistent primitive proatlantal intersegmental artery with a ruptured basilar bifurcation aneurysm. No Shinkei Geka. 2001. 29:775–779.
7. Karasawa J, Terano M, Nishikawa M, Kyoi K, Kikuchi H. Case of persistent bilateral carotid-basilar anastomoses (primitive otic artery and primitive trigeminal artery) with multiple vascular anomalies. No To Shinkei. 1972. 24:91–98. [Japanese].
8. Matsushita A, Yanaka K, Hyodo A, Nose T. Persistent primitive otic artery with IC-cavernous aneurysm. J Clin Neurosci. 2003. 10:113–115.
9. Agnoli AL. Vascular anomalies and subarachnoid hemorrhage associated with persisting embryonic vessels. Acta Neurochir (Wien). 1982. 60:183–199.
10. Cloft HJ, Razack N, Kallmes DF. Prevalence of cerebral aneurysms in patients with persistent primitive trigeminal artery. J Neurosurg. 1999. 90:865–867.
Full Text Links
  • KJR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr