Normal variants: Trigeminal artery

The trigeminal artery is an embryologic connection between the cavernous portion of the internal carotid artery and the basilar artery. It is the most frequently visualized residual primitive connecting artery.  There is a higher association with aneurysms and arteriovenous malformations.

Case #1

Case #1a

Lateral left internal carotid angiogram

A carotid-cavernous sinus fistula is present. There is filling of a small posteriorly directed vessel.

Case #1b

Lateral left vertebral angiogram, early

With manual compression of the carotid artery, a small vessel is seen to feed the carotid-cavernous sinus fistula. This is a persistent trigeminal artery.

Case #1c

Lateral left vertebral angiogram, late

Later in the same run, the carotid-cavernous sinus fistula and internal carotid are being filled from the basilar artery via a trigeminal artery.
 
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