1174. Persistent Trigeminal Artery: A Retrospective clinical study.

Authors: Nishanth Sadashiva, MBBS MCh; Jithender Saini; Gaurav Tyagi, MCh (Bangalore, India)

Introduction:

PTA is the most common, the largest and the most proximally located of the carotid-vertebrobasilar communications, comprising up to 85% of all. Most of the time PTA is incidentally detected during brain imaging for unrelated cause. an array of clinical manifestations have been associated with the PTA with some of them even involving the artery itself have been reported in the literature.

Methods:

Retrospective analysis of all the images either MRI or conventional Cerebral Angiogram which had PPTA were analysed in our Institution.


Results:

We found 30 cases of incidentally detected PTA. The average age of the group was 44.17 years (range 4-75 years), 14 males and 16 females, with a male to female ratio of 1.14. 13 patients had the PTA on the right while 17 had on left. The origins of 21 PTAs were from the proximal part of cavernous ICA on the lateral surface, while 6 from the poster medial surface, 2 originated from the posterior genu of the cavernous ICA segment and another from the petro-cavernous part of ICA.  The most common presentation in our series was aneurysmal subarachnoid hemorrhage, with 7 (23.33%) patients. One had multiple aneurysms. One patient had an unruptured right cavernous aneurysm with third nerve weakness. Trigeminal neuralgia (TN) was the second most common presenting complaints with 5 patients. Three patients presented with and arterio-venous malformation. Vertebro-basilar insufficiency was seen with migraine in one patient. In all there were 3 pediatric age group patients, a 5 years old girl who had bilateral Moya Moya disease. Two children had global developmental delay, one having Vein of Galen malformation while the other had refractory epilepsy following hypoxic birth injury.

Conclusion:

Our study  highlights the anatomical characteristics and clinical associations of a PTA in Neurological care setup.