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Anatomical features and clinical relevance of a persistent trigeminal artery.

Alcalá-Cerra G, Tubbs RS, Niño-Hernández LM - Surg Neurol Int (2012)

Bottom Line: Although persistent trigeminal artery (PTA) is uncommonly identified, knowledge of this structure is essential for clinicians who interpret cranial imaging, perform invasive studies of the cerebral vasculature, and operate this region.Although anatomical reports of PTA anatomy are very scarce, those were analyzed to describe in detail the current knowledge about its anatomical relationships and variants.Additionally, the embryology, classification, clinical implications, and imaging modalities of this vessel are extensively discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Hospital Universitario del Caribe, Universidad de Cartagena. Cartagena de Indias, Colombia.

ABSTRACT

Background: Although persistent trigeminal artery (PTA) is uncommonly identified, knowledge of this structure is essential for clinicians who interpret cranial imaging, perform invasive studies of the cerebral vasculature, and operate this region.

Methods: A review of the medical literature using standard search engines was performed to locate articles regarding the PTA, with special attention with anatomical descriptions.

Results: Although anatomical reports of PTA anatomy are very scarce, those were analyzed to describe in detail the current knowledge about its anatomical relationships and variants. Additionally, the embryology, classification, clinical implications, and imaging modalities of this vessel are extensively discussed.

Conclusions: Through a comprehensive review of isolated reports of the PTA, the clinician can better understand and treat patients with such an anatomical derailment.

No MeSH data available.


Related in: MedlinePlus

Origin of the artery is identifiable at posterolateral wall of intracavernous segment of internal carotid (IC). It courses adjacent to lateral wall of cavernous sinus, closely related with abducens nerve (VI), which passes over the artery in an oblique direction toward the superior orbital fissure. The ophthalmic branch of trigeminal nerve (V) faces medially with its lateral side. In this specimen, it became extradurally through a channel delimited superiorly by the posterior petroclinoid ligament and inferiorly by a groove of the lateral side of dorsum sellae (DS). Oculomotor nerve (III)
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Figure 2: Origin of the artery is identifiable at posterolateral wall of intracavernous segment of internal carotid (IC). It courses adjacent to lateral wall of cavernous sinus, closely related with abducens nerve (VI), which passes over the artery in an oblique direction toward the superior orbital fissure. The ophthalmic branch of trigeminal nerve (V) faces medially with its lateral side. In this specimen, it became extradurally through a channel delimited superiorly by the posterior petroclinoid ligament and inferiorly by a groove of the lateral side of dorsum sellae (DS). Oculomotor nerve (III)

Mentions: The detailed anatomy of PTA is lacking in the literature and is composed primarily of scattered cadaveric case reports.[3543475257] The origin of the PTA is usually in the posterior or lateral surface of the intracavernous ICA just proximal to the origin of the meningohypophyseal trunk. Less commonly, the PTA arises more proximally from the ICA, before the proximal dural ring and there are also reports of it branching from the petrous ICA.[5356] Suttner et al. made a detailed microscopic description of a PTA found in a cadaveric specimen. This artery arose from the superomedial portion of the distal horizontal segment of the intracavernous carotid artery and coursed medially and immediately posteroinferiorly, passing between the posterior bend of the ICA laterally and the pituitary gland medially. Crossing the cavernous sinus, the PTA has been observed to cross superior as well as inferior to the oculomotor, trochlear, and abducent nerves and is usually medial to the ophthalmic division of the trigeminal nerve [Figure 2]. Conversely, when the PTA arises from the posteromedial aspect of the intracavernous segment of the ICA, it becomes extradural at the dorsum sellae, being medial to the abducent nerve in the majority of cases.[53] Along its intracavernous course, the PTA may give rise to the inferior hypophyseal and dorsal meningeal arteries and branches to the trigeminal nerve.[47] Ohshiro et al. also described the origin of arteries from the PTA including a well developed meningohypophyseal trunk.[35] The PTA may also send branches to the pons.[30354347] Salas et al. and Khodadad described pontine perforating branches of the PTA.[262743]


Anatomical features and clinical relevance of a persistent trigeminal artery.

Alcalá-Cerra G, Tubbs RS, Niño-Hernández LM - Surg Neurol Int (2012)

Origin of the artery is identifiable at posterolateral wall of intracavernous segment of internal carotid (IC). It courses adjacent to lateral wall of cavernous sinus, closely related with abducens nerve (VI), which passes over the artery in an oblique direction toward the superior orbital fissure. The ophthalmic branch of trigeminal nerve (V) faces medially with its lateral side. In this specimen, it became extradurally through a channel delimited superiorly by the posterior petroclinoid ligament and inferiorly by a groove of the lateral side of dorsum sellae (DS). Oculomotor nerve (III)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475875&req=5

Figure 2: Origin of the artery is identifiable at posterolateral wall of intracavernous segment of internal carotid (IC). It courses adjacent to lateral wall of cavernous sinus, closely related with abducens nerve (VI), which passes over the artery in an oblique direction toward the superior orbital fissure. The ophthalmic branch of trigeminal nerve (V) faces medially with its lateral side. In this specimen, it became extradurally through a channel delimited superiorly by the posterior petroclinoid ligament and inferiorly by a groove of the lateral side of dorsum sellae (DS). Oculomotor nerve (III)
Mentions: The detailed anatomy of PTA is lacking in the literature and is composed primarily of scattered cadaveric case reports.[3543475257] The origin of the PTA is usually in the posterior or lateral surface of the intracavernous ICA just proximal to the origin of the meningohypophyseal trunk. Less commonly, the PTA arises more proximally from the ICA, before the proximal dural ring and there are also reports of it branching from the petrous ICA.[5356] Suttner et al. made a detailed microscopic description of a PTA found in a cadaveric specimen. This artery arose from the superomedial portion of the distal horizontal segment of the intracavernous carotid artery and coursed medially and immediately posteroinferiorly, passing between the posterior bend of the ICA laterally and the pituitary gland medially. Crossing the cavernous sinus, the PTA has been observed to cross superior as well as inferior to the oculomotor, trochlear, and abducent nerves and is usually medial to the ophthalmic division of the trigeminal nerve [Figure 2]. Conversely, when the PTA arises from the posteromedial aspect of the intracavernous segment of the ICA, it becomes extradural at the dorsum sellae, being medial to the abducent nerve in the majority of cases.[53] Along its intracavernous course, the PTA may give rise to the inferior hypophyseal and dorsal meningeal arteries and branches to the trigeminal nerve.[47] Ohshiro et al. also described the origin of arteries from the PTA including a well developed meningohypophyseal trunk.[35] The PTA may also send branches to the pons.[30354347] Salas et al. and Khodadad described pontine perforating branches of the PTA.[262743]

Bottom Line: Although persistent trigeminal artery (PTA) is uncommonly identified, knowledge of this structure is essential for clinicians who interpret cranial imaging, perform invasive studies of the cerebral vasculature, and operate this region.Although anatomical reports of PTA anatomy are very scarce, those were analyzed to describe in detail the current knowledge about its anatomical relationships and variants.Additionally, the embryology, classification, clinical implications, and imaging modalities of this vessel are extensively discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Hospital Universitario del Caribe, Universidad de Cartagena. Cartagena de Indias, Colombia.

ABSTRACT

Background: Although persistent trigeminal artery (PTA) is uncommonly identified, knowledge of this structure is essential for clinicians who interpret cranial imaging, perform invasive studies of the cerebral vasculature, and operate this region.

Methods: A review of the medical literature using standard search engines was performed to locate articles regarding the PTA, with special attention with anatomical descriptions.

Results: Although anatomical reports of PTA anatomy are very scarce, those were analyzed to describe in detail the current knowledge about its anatomical relationships and variants. Additionally, the embryology, classification, clinical implications, and imaging modalities of this vessel are extensively discussed.

Conclusions: Through a comprehensive review of isolated reports of the PTA, the clinician can better understand and treat patients with such an anatomical derailment.

No MeSH data available.


Related in: MedlinePlus