Intracranial Aneurysm Associated With Persistent Primitive Trigeminal Artery: Incidence, Characteristic, Risk Factors, and Clinical Treatment

Objective: To evaluate the application of 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) in the diagnosis of persistent primitive trigeminal artery (PPTA) associated with intracranial aneurysm and retrospectively evaluate its incidence, characteristic, risk factors, and clinical treatment.Methods: 3D-TOF-MRA at 3.0 T was performed for 2488 patients with neurological syndrome and 2 neuroradiologists analyzed the image data. Patients with PPTA were included in this study. In patients with intracranial aneurysm associated with PPTA, 7 variables were considered for the univariate analysis to evaluate the risk factors. In addition, the management of aneurysm was evaluated.Results: Nineteen patients presented with PPTA of whom 8 were found to be associated with intracranial aneurysm. The aneurysms were located at the anterior communicating artery (n=3), the posterior communicating artery segment of the internal carotid artery (n=3), at the middle cerebral artery (n=1), and at the trunk of the PPTA (n=1). Univariate analysis showed that intracranial aneurysms with PPTA mostly occurred in women. Coiling embolization was conducted on 2 patients with ruptured aneurysm, and a conservative treatment was given for the remaining 6 patients with unruptured aneurysms.Conclusions: 3D-TOF-MRA is a useful method to detect and classify PPTA. The incidence of PPTA associated with intracranial aneurysm is higher compared with previous reports and is mostly seen in women.