{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T05:26:50Z","timestamp":1675488410206},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nCerebrovascular embryologic development is characterized by the presence of four well-described carotid-vertebrobasilar (VB) anastomoses. As the fetal hindbrain matures and the VB system develops, these connections involute, yet some may persist into adulthood. The persistent primitive trigeminal artery (PPTA) is the most common of these anastomoses. In this report, we describe a unique variant of the PPTA and a four-way division of the VB circulation.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA female in her 70s presented with a Fisher Grade 4 subarachnoid hemorrhage. Catheter angiography revealed a fetal origin of the left posterior cerebral artery (PCA) giving rise to a left P2 aneurysm which was coiled. A PPTA arose from the left internal carotid artery and supplied the distal basilar artery (BA) including the superior cerebellar arteries bilaterally and the right but not left PCA. The mid-BA was atretic and the anterior inferior cerebellar artery-posterior inferior cerebellar artery complexes were fed solely from the right vertebral artery.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nOur patient\u2019s cerebrovascular anatomy represents a unique variant of the PPTA not well described in the literature. This demonstrates how hemodynamic capture of the distal VB territory by a PPTA is sufficient to prevent fusion of the BA.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_950_2022","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T06:29:42Z","timestamp":1675405782000},"page":"40","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A persistent trigeminal artery demonstrates cerebrovascular embryologic development"],"prefix":"10.25259","volume":"14","author":[{"given":"Richard","family":"Bram","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason L.","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred P.","family":"See","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cerebrovascular Surgery and Interventions Center, Boston Children\u2019s Hospital, Harvard Medical School, Boston, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gursant S.","family":"Atwal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"10.25259\/SNI_950_2022\/ref-1","doi-asserted-by":"crossref","first-page":"E746","DOI":"10.1227\/01.neu.0000317327.17225.f8","article-title":"Persistent trigeminal artery terminating in the posterior inferior cerebellar artery: Case report","volume":"62","author":"Ali","year":"2008","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_950_2022\/ref-2","doi-asserted-by":"crossref","first-page":"e401","DOI":"10.1016\/j.wneu.2019.09.042","article-title":"Prevalence and clinical implications of the primitive trigeminal artery and its variants: A meta-analysis","volume":"133","author":"Brzegowy","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_950_2022\/ref-3","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3171\/jns.1999.90.5.0865","article-title":"Prevalence of cerebral aneurysms in patients with persistent primitive trigeminal artery","volume":"90","author":"Cloft","year":"1999","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_950_2022\/ref-4","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3171\/jns.1971.35.5.0601","article-title":"Intracranial aneurysm on a persistent primitive trigeminal artery. 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