PMC9238197_01
A right persistent trigeminal artery variant discovered incidentally in a 49-year-old female with cervical trauma.. A. Lateral projection digital subtraction angiography image of the right internal carotid artery. Early arterial phase image depicts the persistent trigeminal artery variant (arrow), arising from the precavernous portion of the right internal carotid artery and running to the posterior fossa.. B. Late arterial phase image depicts that the persistent trigeminal artery variant supplies the superior part of the right cerebellar hemisphere (arrowheads).. C. Time-of-flight MR angiography maximum intensity projection image. The apicoposterior view of the intracranial arteries depicts the persistent trigeminal artery variant (arrows) running to the right superior cerebellar artery territory, below the right posterior cerebral artery (arrowheads).. D. Lateral view of the right internal carotid artery depicts the persistent trigeminal artery variant (arrow) arising from the precavernous portion of the right internal carotid artery and running to the posterior fossa.. E. Apicoposterior view of the vertebrobasilar arteries depicts the persistent trigeminal artery variant (arrow), without an interposing segment of the basilar artery. This artery supplies the superior cerebellar artery territory (arrowhead).. F. Schematic illustration of Saltzman Type IIIa, IIIb, and IIIc PTA.. Focal non-fusion of the longitudinal neural artery with the trigeminal artery at the levels of the SCA, AICA, and PICA resulted in the PTA terminating in the SCA (Saltzman IIIa), AICA (Saltzman IIIb), and PICA (Saltzman IIIc), respectively (arrows).. AICA = anterior inferior cerebellar artery, BA = basilar artery, ICA = internal carotid artery, MCA = middle cerebral artery, PCA = posterior cerebral artery, PCOM = posterior communicating artery, PICA = posterior inferior cerebellar artery, PTA = persistent trigeminal artery, SCA = superior cerebellar artery, VA = vertebral artery
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A follow-up MRA at 15 months after the injury confirmed that the PTAV contributed to the ipsilateral SCA without joining the basilar artery (Fig. 1C-E).