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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 174-178
DOI: 10.1055/s-0044-1787085
Research Article

A Case of Cerebral Infarction due to Internal Carotid Artery Occlusion Accompanied by Persistent Primitive Trigeminal Artery

Authors

  • Hiroyuki Abe

    1   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan
    3   Department of Neurosurgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan

  • Kentaro Mori

    1   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Issei Fukui

    1   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Akira Tamase

    1   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Ryotaro Yamashita

    2   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Mutsuki Takeda

    2   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Tatsu Nakano

    2   Department of Neurology, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Motohiro Nomura 

    1   Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Kanagawa, Japan

  • Tetsuya Yamamoto

    3   Department of Neurosurgery, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
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Abstract

An 85-year-old woman with a history of diabetes mellitus became aware of motor weakness of the left lower extremity. Magnetic resonance imaging showed multiple small cerebral infarctions in the right corona radiata. Angiography revealed persistent primitive trigeminal artery (PPTA) originating from the right internal carotid artery (ICA) and connecting to basilar artery, and the right ICA occluded distal to PPTA. Collateral blood circulation had developed, and sufficient collateral blood flow was expected. From these findings, the right ICA was considered to show stenosis due to atherosclerotic changes before occlusion. Conservative treatment was conducted with the transoral administration of rivaroxaban. It is important to correctly diagnose the anatomy and existence of an anomalous vessel in a stroke patient, not only when endovascular treatment is planned, but also for conservative medical treatment. Rapid and accurate radiological examinations facilitate safe and effective treatment.

Keywords

persistent primitive trigeminal artery - internal carotid artery - occlusion - cerebral infarction

Authors' Contributions

H.A. and K.M. were involved in drafting of manuscript, critical revision, and treatment of patient. I.F., A.T., R.Y., M.T., and T.N. drafted and critically revised the manuscript. M.N. contributed to study conception and design, drafting of manuscript, critical revision, and treatment of patient.


Ethical Approval and Patients' Consent

This study was approved by the Ethics Committee of Yokohama Sakae Kyosai Hospital. Need for written patient consent form was waved by the Ethics Committee because data were deidentified.




Publication History

Article published online:
05 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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