Due attention should be paid to persistent trigeminal artery in trigeminal neuralgia

Abstract Objectives: Persistent trigeminal artery (PTA) is a rare anastomoses vessel, and also a rarely reported culprit vessel in trigeminal neuralgia (TN). In this study, we aimed to analysis the incidence of PTA in TN.Methods: 297 patients with TN underwent high-resolution 3.0T magnetic resonance imaging (MRI) test between July 2020 and July 2022. The sequences included: axial cerebral TSE T2-weighted imaging, axial cerebral dark fluid T1/T2-weighted imaging, high-resolution T2-weighted SPACE sequences, high-resolution T2-weighted three-dimensional-time of flight magnetic resonance angiography (3D-TOF MRA) sequences. The images were interpreted by one radiologist and one neurosurgical professor. Incidence of PTA in patients with TN was calculated accordingly.Results: In the study, 4 cases of PTA were found in the right side of patients with TN, and 3 cases of the PTA were the culprit vessels of TN, one PTA was on the unaffected side but hardly contact to the trigeminal nerve. The incidence of PTA in TN was 1.35%, furthermore, the incidence of culprit PTA was 1.01%. Conclusions: High-resolution MRI could detect rare culprit vessels of TN, the incidences of PTA and culprit PTA in patient with TN were 1.35% and 1.01% in current study. The important role of PTA should be paid due attentions.