PMC9990760_01
PMC9990760_02
(a) Anterior-Posterior (AP) left internal carotid artery (ICA) angiography demonstrates a persistent primitive trigeminal artery (PPTA) (black arrow) supplying the right posterior cerebral artery (PCA) and SCAs bilaterally. (b) Lateral left ICA angiography further demonstrates the PPTA (Black arrow) and a left P2 aneurysm. (c) AP right vertebral artery (VA) angiography demonstrates the proximal basilar trunk with anterior inferior cerebellar artery - posterior inferior cerebellar artery complexes bilaterally. (d) Lateral right VA angiography further demonstrates the blood supply to the caudal cerebellum. (e) Lateral left VA angiography demonstrates termination after the sulcus arteriosus as meningeal branches. (f) Reconstructed oblique left ICA 3-dimensional rotational angiography demonstrates a left fetal-type PCA giving rise to the P2 aneurysm. (g) Diagrammatic representation of the patient's cerebrovascular system. Solid black lines represent blood vessels of the VB system while solid grey line represents the carotid circulation. Dotted black lines indicate a typical vessel that is absent. PPTA is indicated by black arrow.
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F1
After the placement of an external ventricular drain for the treatment of acute hydrocephalus, she underwent a diagnostic cerebral angiogram which revealed a multilobular left P2 aneurysm measuring 8.0 mm in maximum dimension [Figure 1].