A case of primitive trigeminal artery infarction

Within minutes following an altercation with police, a 55-year-old man noted onset of speech difficulty and right-sided weakness without headache or neck pain. Dysarthria and right hemiparesis (grade 4/5) without ocular disturbance was found. Left ventral hemipontine infarction was documented from the ipsilateral tortuous primitive trigeminal artery (figure). Cerebral angiogram failed to reveal underlying arterial dissection.

Neurology Podcasts™

Neurology& Podcast Cover


Figure       Get Neurology® for your iPad.®

White arrow points to the primitive trigeminal artery (A–D). MRI, fluid-attenuated inversion recovery sequence, demonstrating the left ventral pontine infarction (A). Magnetic resonance angiography demonstrates proximal hypoplastic-stenotic vertebrobasilar system (B). Selective left internal carotid artery angiogram: lateral (C) and anteroposterior view (D) (same viewing angle as in B). Triangular arrowhead points to the left internal carotid artery (B–D).

Persistent anastomosis from a cavernous portion of internal cerebral artery to rostral basilar artery is unusual, with an estimated incidence of 0.2%.1 Although the artery has been implicated as a conduit of a carotid artery to posterior cerebral artery distribution embolic stroke,2 our case illustrates that localized occlusive process may also occur.

This entry was posted in Uncategorized. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s