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Congenital Arterial Anastomosis
Incidentally noted imaging finding. Ax , axial; CT , computed tomography; CTA , CT angiography; MIP , maximum intensity projection; PTA, persistent trigeminal artery; Recon , reconstruction; RICA, right internal carotid artery.
Incidentally noted imaging finding. Ax , axial; Cor , coronal; CTA , computed tomography angiography; MRA , magnetic resonance angiography; Recon , reconstruction.
Incidentally noted imaging finding. CTA , computed tomographic angiography; LVA, left vertebral artery; MIP , maximum intensity projection; Recon , reconstruction.
DESCRIPTION OF FINDINGS
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Case A: Multiplanar thick maximum intensity projections and a three-dimensional (3D) vitrea image demonstrate a large anomalous vessel arising from the petrocavernous junction of the right ICA, near the posterior genu. It takes a parasellar course around the dorsum sellae to join the mid basilar artery and is consistent with a persistent trigeminal artery.
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Case B: Axial source computed tomography angiography, magnetic resonance angiography, and 3D vitrea images demonstrate an anomalous vessel from the left ICA coursing through an enlarged hypoglossal canal and connecting with the proximal basilar artery. Its path through the hypoglossal canal is a clue that this vessel is a persistent hypoglossal artery.
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Case C: 3D vitrea images and sagittal thick maximum intensity projection demonstrate a robust vessel arising from the left external carotid artery, coursing horizontally across the atlantooccipital space, and giving rise to the left intradural vertebral artery, diagnostic of a type 2 proatlantal artery.
Diagnosis
Case A
Persistent trigeminal artery
Case B
Persistent hypoglossal artery
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