Arteria trigemina

Persistent primitive trigeminal artery (PPTA) is one of the persistent carotid-vertebrobasilar anastomoses. It is present in 0.1-0.6% of cerebral angiograms and is usually unilateral.

In utero, the trigeminal artery supplies the basilar artery before the development of the posterior communicating and vertebral arteries. The PTA arises from the junction between petrous and cavernous ICA, and runs posterolaterally along the trigeminal nerve (41%), or crosses over or through the dorsum sellae (59%). Vertebral, posterior communicating and caudal basilar arteries are often hypoplastic.

There are 2 types of PTA:

  • Saltzman type I: PTA supplies the distal vertebrobasilar arteries. The posterior communicating artery is absent and the caudal basilar is absent or hypoplastic with hypoplastic distal vertebral arteries.
  • Saltzman type II: PTA supplies the superior cerebellar arteries with the posterior cerebral arteries supplied by the posterior communicating artery.

Radiographic features

CT angiography / MRI

A characteristic tau sign  or trident sign is described as its appearance on sagittal CTA or MR images.

Related pathology

There is an association with intracranial aneurysms and vascular malformations.

See also

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