Yamada Shoko Merrit, Harada Takane, Terada Shuzo, Nehashi Yoshio, Mori Noriko
Department of Internal Medicine, Japan Community Health Care Organization (JCHO): Sakuragaoka Hospital, 13-23 Sakuragaoka, Shimizu-ku, Shizuoka City, Shizuoka Prefecture 424-8601, Japan.
Radiol Case Rep. 2024 Mar 18;19(6):2256-2259. doi: 10.1016/j.radcr.2024.02.095. eCollection 2024 Jun.
Patients with a persistent primitive trigeminal artery frequently have a poorly developed vertebrobasilar arterial system. However, they are not at higher risk of stroke and most are asymptomatic. Left cerebral watershed infarction was identified in a 75-year-old man who presented with aphasia and disorientation on magnetic resonance image (MRI). Additional imaging studies also demonstrated a right persistent primitive trigeminal artery, aplastic basilar artery, and 47% left internal carotid artery stenosis. Antiplatelet medication was administered and he was discharged 2 weeks after admission on aspirin. At the 4-month follow-up, cerebral blood flow in the left watershed territory was still decreased; however, no recurrent stroke had occurred. Although the indication for surgical or endovascular intervention for internal carotid artery stenosis is primarily determined by the degree of stenosis, cerebral blood flow evaluation is recommended in patients with internal carotid artery stenosis and a persistent primitive trigeminal artery.
患有持续性原始三叉动脉的患者，其椎基底动脉系统往往发育不良。然而，他们发生中风的风险并不高，大多数人没有症状。一名75岁男性因失语和定向障碍就诊，磁共振成像（MRI）检查发现左侧大脑分水岭梗死。其他影像学检查还显示右侧存在持续性原始三叉动脉、基底动脉发育不全以及左侧颈内动脉狭窄47%。给予抗血小板药物治疗，患者入院2周后服用阿司匹林出院。在4个月的随访中，左侧分水岭区域的脑血流量仍然减少；然而，没有发生复发性中风。虽然颈内动脉狭窄的手术或血管内介入治疗指征主要由狭窄程度决定，但对于患有颈内动脉狭窄和持续性原始三叉动脉的患者，建议进行脑血流量评估。
