We report a hitherto undescribed persistent carotid vertebral anastomosis associated with ipsilateral internal carotid artery agenesis and bilateral duplication of the intradural vertebral arteries. This rare anomaly was detected on MRI, supplemented by CT angiography while evaluating for cause trigeminal neuralgia in a 37-year-old woman. The aberrant vessel was seen to cause thinning and lateral displacement of the left trigeminal nerve on CISS 3D images. Also noted was a bilateral vertebral artery duplication of the PSA variant with the posterior inferior cerebellar artery arising from the medial limb of the duplication on the left.
PadgetDH. The development of the cranial arteries in the human embryo. Contrib Embryol1948; 32: 207–262.
2.
LieTA. Congenital anomalies of the carotid arteries, Amsterdam: Excerpta Medica, 1968, pp. 44–49.
3.
GivenCA2ndHuang-HellingerFBakerMDet al.Congenital absence of the internal carotid artery: Case reports and review of the collateral circulation. AJNR Am J Neuroradiol2001; 22: 1953–1959.
4.
ItoSMiyazakiHIinoNet al.Unilateral agenesis and hypoplasia of the internal carotid artery: A report of three cases. Neuroradiology2005; 47: 311–315.
5.
QuintDJSilbergleitRYoungWC. Absence of the carotid canals at skull base CT. Radiology1992; 182: 477–481.
6.
Lasjaunias P, Berenstein A and ter Brugge KG. Surgical neuroangiography, part 1: Clinical & vascular anatomy & variations. Chapter 4. 2nd ed. Berlin Heidelberg: Springer-Verlad, 2001, pp.265–266.
7.
Lasjaunias P, Berenstein A and ter Brugge KG. Surgical neuroangiography, part 1: Clinical & vascular anatomy & variations. Chapter 3. 2nd ed. Berlin Heidelberg: Springer-Verlad, 2001, pp.235–241.
8.
QuainR. The anatomy of the arteries of the human body and its applications to pathology and operative surgery, London: Taylor and Walton, 1844, pp. 550.
9.
SiqueiraMPiskeROnoMet al.Cerebellar arteries originating from the internal carotid artery. AJNR Am J Neuroradiol1993; 14: 1229–1235.
DebrunGMDavisKRNautaHJet al.Treatment of carotid cavernous fistulae or cavernous aneurysms associated with a persistent trigeminal artery: Report of three cases. AJNR Am J Neuroradiol1988; 9: 749–755.
BoykoOBCurnesJTBlatterDDet al.MRI of basilar artery hypoplasia associated with persistent primitive trigeminal artery. Neuroradiology1996; 38: 11–14.
14.
FukudaMKameyamaSTakahashiHet al.Trigeminal neuralgia caused by the vertebral artery associated with primitive trigeminal artery and agenesis of the internal carotid artery. Neurol Med Chir (Tokyo)1998; 38: 367–370.
15.
UchinoASawadaAHirakawaNet al.Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia. Eur Radiol2002; 12: 2339–2342.
