Carotid-vertebrobasilar anastomoses generally disappear during embryogenesis. However, if a problem exists during regression, these arteries persist in adult period and are named as persistent arteries. Their persistence in adult patients is sometimes pathological and may result in the development of an aneurysm or a compressive syndrome. These anastomoses are frequently associated with proximal or distal arterial pathology. Herein, we present three rare variants of carotid-vertebrobasilar anastomoses: a persistent trigeminal artery, persistent hypoglossal artery, and a persistent otic artery. These variants should be kept in mind to avoid errors both in clinical reporting and surgical procedures.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6100572PMC
http://dx.doi.org/10.5334/jbr-btr.1167DOI Listing

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We present a case of a rare vascular variation of the persistent hypoglossal artery (PHA) in a 57-year-old Caucasian female patient with a medical history of poorly controlled hypertension, headaches, diabetes mellitus, and depression. This anatomical variation was initially misdiagnosed as an internal carotid artery (ICA) aneurysm during the extracranial carotid Doppler imaging conducted due to nonspecific symptoms of cerebrovascular insufficiency, manifesting as coordination disturbances. PHA is one of the four vertebrobasilar anastomoses, originating from the cervical segment of the ICA.

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Bilateral concurrent type I and type II persistent proatlantal arteries: A case report.

Radiol Case Rep

November 2024

Department of Radiology, Robert Wood Johnson University Hospital, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Transient embryonic carotid-vertebrobasilar anastomoses can intermittently persist beyond the embryonic period. These vascular anomalies are often serendipitously identified during evaluation for unrelated disease states and pathologies. The persistent proatlantal intersegmental artery is one such recognized rare fetal anastomotic connection, often arising unilaterally.

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Article Synopsis
  • - Persistent trigeminal artery disease is a common type of persistent carotid-vertebrobasilar anastomosis, often found unilaterally and detected through imaging methods like MRA and angioCT.
  • - While it can cause symptoms such as headaches or nerve palsies, it frequently remains asymptomatic and is discovered incidentally.
  • - A case is presented involving a young woman who found out she had this malformation during an MRA after suffering from persistent headaches that did not improve with treatment.
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Background: We aimed to analyze the variability of the permanent trigeminal artery (PTA) and its relationship with cerebrovascular disease.

Methods: To analyze the variability of the PTA and its relationship with cerebrovascular disease by using the terms "primitive trigeminal artery", "persistent primitive trigeminal artery", " persistent trigeminal artery variant", "PPTA", "PTAV", "carotid- basilar anastomoses", "carotid-vertebrobasilar anastomoses", "persisting embryonic vessels" were used as keywords, and the English-language literature related to PTA and cerebrovascular diseases published in PubMed, EMBAS, and Web of Science databases from 2000 to 2022 were searched by using "subject terms + free words". A meta-analysis of the collected data was performed using stata14.

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Persistent trigeminal artery (PTA) is the most common remnant of the primitive carotid-vertebrobasilar anastomoses, which typically form and obliterate during the early stages of human embryonic development. While PTA can be non-pathologic and is usually an incidental finding, it is also associated with various other vascular abnormalities, such as arteriovenous malformations and fistulae, but most commonly cerebral aneurysms. In these cases, aneurysms are usually reported in the anterior cerebral circulation or in the PTA trunk itself; to date, only one report exists of an associated aneurysm in the posterior circulation (basilar artery).

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