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The authors described two cases with primitive trigeminal artery. Case 1 was a 32-year-old woman who suffered dizziness and a serious pulsatile intracranial bruit on the left ear, and sometimes associated with pulsatile intracranial bearing-pain on the left temporal side six months before she was admitted to the hospital. She also suffered from obvious diplopia on left lateral gaze for the last 5 months. She had suffered no recent trauma. Magnetic resonance imaging(MRI) demonstrated a suspected intracranial aneurysm located in left cavernous sinus. Digital subtraction angiography (DSA) was performed and a primitive trigeminal artery-cavernous sinus fistula in left side was found. Intraluminal occlusion of the fistula was successfully performed immediately after angiography using 6 Guglielmi detachable coils (GDC), and the patient was cured finally. Case 2 was a 28-year-old woman who suffered a serious intermittent cephalodynia associated with soreness on the left body two years before she was admitted to the hospital. She had suffered no recent trauma. Magnetic resonance angiography(MRA) demonstrated a suspected intracavernous aneurysm of the right internal carotid artery, Digital subtraction angiography (DSA) was performed. Right internal carotid angiography showed a primitive trigeminal artery (PTA) run between the cavernous segment of the internal carotid artery and the distal portion of the basilar artery. On initiation of PTA of R-ICA a small wide-necked saccular aneurysm was incidentally visualized. The aneurysm was successfully embolized after angiography using 2 Stent (Neuroform, 4.5mmm × 20mmm)-assisted detachable coils (Matrix), the ICA and PTA were preserved, and the patient was cured finally.
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原始三叉动脉海绵窦瘘栓塞治疗及并发症和处理一例
患者男,22岁.1年前左侧眉弓跌伤,7个月后无明显诱因出现左眼球突出,伴结膜充血、溢汨.体检显示:右眼裸视力0.5,左眼裸视力0.4;非接触(NCT)眼压计测压:右眼16 mm Hg(1 mm Hg=0.133 kPa);左眼20 mm Hg;眼突出度右眼13 mm,左眼21;mm,左侧结膜充血,眶周可闻及收缩期吹风样杂音.辅助检查:头颅MR检查显示左侧颈内动脉海绵窦段增粗迂曲,眼上静脉明显增粗.动态增强扫描显示左侧海绵窦与颈内动脉交通,海绵窦引流静脉增粗,以左眼上静脉为重(图1).脑血管造影见基底动脉与左颈内动脉之间原始三义动脉(primitive trigeminal aftery,PTA)开放显影,PTA海绵窦段破裂形成PTA-海绵窦瘘(图2,3).治疗
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CTA诊断永存三叉动脉1例并文献复习
永存三叉动脉(persistent primitive trigeminal artery,PP-TA)又称原始三叉动脉或持续性三叉动脉,是一种永久性颈内动脉(ICA)和基底动脉(BA)异常吻合血管,是一种较罕见的脑血管变异.笔者报道1例偶然发现的永存三叉动脉,并对永存三叉动脉进行文献复习.