PERSISTENT TRIGEMINAL ARTERY CASE AND ISCHEMIC STROKE

초록

Background Persistent trigeminal artery(PTA) is a rare embryonic connection between the cavernous part of the internal carotid artery and the basilar artery. PTA is often associated with intracranial aneurysm, arteriovenous malformations, Moyamoya and cerebral ischemia and is classified according to the Saltzman criteria and PTA location. However, the clinical significance of PTA subtype remained unknown. We experienced one case of PTA case and reviewed the literature of PTA cases. Methods We reviewed the previous articles and our case, and found 20 cases of ischemic stroke and transient cerebral ischemic attack(TIA) as well as 37 cases of other diseases. We compared the Saltzman type, PTA location and combined vessel anomaly between two groups. Results Among cases of ischemic stroke and transient cerebral attack, whose images could be available 73.3% patients had brain stem infarction(pontine infarct, 53.3%;midbrain infarct, 13.3% and PCA infarct, 6.7%) and 20.0% patients had TIA. 63.2 % had Saltzman type 1 and 56.3% patients had median type. Among 37 patients without cerebral ischemia, 62.1% had Saltzman type 1 and 53.8% had the median type of PTA. However, the cerebral artery stenosis is more common in ischemic stroke groupthan the control group(57.1% vs 5.3%, p< 0.01) Conclusion and discussion This results suggested that PTA might be associated with posterior circulation ischemia. Although there seemed to be no difference in type of PTA between ischemic stroke and other lesions, the cerebral artery stenosis, combined with PTA might cause ischemic attack.