A case of persistent primitive trigeminal artery associated with Wallenberg's syndrome

Abstract

A case of persistent primitive trigeminal artery (PTA) associated with Walenberg's syndrome is reported. Cerebral angiogram revealed hypoplastic vertebral arteries, occlusion of left posterior inferior cerebellar artery (PICA) and PTA on the right side.
Vertebrobasilar insufficiency with PTA has been supposed to be due to microembolization from an atherosclerotic carotid artery to basilar artery (BA) via PTA. However, in our case, this mechanism is not proper, both because occluded vessel is PICA arising from vertebral artery proximal to the junction of PTA and BA and angiogram showed neither atherosclerotic plaque at the carotid artery nor stenosis.
It is considered likely that the patient's illness was due to a thrombotic occlusion of PICA, probably atherosclerosis and abnormal vertebrobasilar circulation caused by hypoplasia of vertebral arteries.