Erklärt eine persistierende Arteria trigemina primitiva ein kardioembolisches Muster ischämischer Läsionen im zerebralen MRT

The case presented here shows that a persistent primitive trigeminal artery (PPTA) may suggest a cardioembolic pattern of ischemic lesions on brain imaging, despite an embolic source identified within the carotid artery and without evidence of a more proximal embolic focus in a thorough diagnostic work-up. The PPTA is the most common persistent carotid-basilar anastomosis. The PPTA connects the C4 segment of the internal carotid artery and the basilar artery. Its frequency is between 0.06-0.76% of the population. In daily routine, PPTA remains mostly undetected. PPTA is detected only by angiography. PPTA is associated with alterations in the vertebrobasilar circulation, especially with hypoplasia of the proximal vessel sections. There are some case reports on vertebrobasilar embolic ischemia in patients with PPTA, but there does not seem to be any significant association with stroke or transient ischemic attacks in patients with PPTA.