Summary
Objective
Fusiform aneurysms of the persistent trigeminal artery are rare and endovascular treatment
of these aneurysms has not been attempted previously. We describe a case of persistent
trigeminal artery with a fusiform aneurysm in its middle third, managed using Guglielmi
detachable coils (GDC).
Clinical Presentation
A 50-year-old, diabetic and hypertensive patient presented with sudden onset headache
and neck stiffness. On examination, she was conscious but disoriented, without cranial
nerve or sensorimotor deficits. Four-vessel cerebral digital subtraction angiography
revealed a fusiform aneurysm of the middle third of a persistent trigeminal artery
on the left side with adult type posterior cerebral arteries.
Intervention
Guglielmi detachable coils were used for occlusion of the persistent trigeminal artery.
Results
The procedure was well tolerated but delayed ischemic neurological deficits developed
due to vasospasm.
Conclusions
(1) In spite of angiographically documented independence of the anterior and posterior
cerebral circulation, occlusion of a persistent trigeminal artery using endovascular
techniques may result in posterior circulation stroke due to a number of factors,
including occlusion of brainstem perforators taking origin from the persistent trigeminal
artery or vasospasm. (2) The timing for endovascular intervention following aneurysmal
rupture remains poorly defined.
Keywords
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Article info
Publication history
Accepted:
June 18,
2004
Received:
February 12,
2004
Identification
Copyright
© 2005 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
