A Case of Persistent Trigeminal Artery Presenting as Vertebrobasilar Insufficiency

ABSTRACT

The persistent trigeminal artery(PTA) is the most common type of persistent carotid-basilar anastomosis, usually diagnosed by cerebral angiography or autopsy. PTA is usually associated with hypoplasia or atresia of the vertebrobasilar artery and may result in symptoms of vertebrobasilar insufficiency caused by decreased perfusion of the brainstem. We report a patient with PTA who presented with symptoms of vertebrobasilar insufficiency. An 80-year-old woman with a history of hypertension, hyperlipidemia, and unstable angina pectoris presented with recurrent dizziness, dysarthria, and a tendency to fall to the left side. PTA was identified with hypoplasia of the vertebrobasilar system and mild stenosis of the bilateral proximal internal carotid arteries on brain MR angiography and cerebral angiography.