The rarely diagnosed persistent trigeminal artery (PTA) originates from the posterior bend or lateralwall of the intracavernous carotid artery and is the most common occurring type of remnant primitivefetal arteries. Even if PTA is uncommon, information and awareness about it could be of great help forclinicians dealing with cranial vascular imaging and operating this region. In addition, it could give asupporting response to the presence of a wide range of idiopathic and unresponsive disturbs that sometimesare erroneously interpreted and treated. There are very few published scientific reports of coexisting PTA and unilateral trigeminal neuralgia and migraine-cephalgia (MC). In this review we describe few reportedand unreported cases regarding the manifestation of unresponsive trigeminal neuralgia and migrainedue to the presence of PTA. Patients usually present with a clinical symptomatology with unstable bloodhypertension, pain of typical trigeminal neuralgia and MC that cover unilaterally the occipital area overthe second and third divisions of the nerve. The outbreaks may often become more severe during physicalexertion, stress and hypertension. Angio-MRI may reveal the PTA with an occasional occurrence of parietalcavernoma. We also describe a case of chronic left MC case associated with an adjacent PTA close to thewas safely treated by bio-identical testosterone, human placenta extract (HPE), b-nicotinamide adeninedinucleotide (NADH) and low dose amlopidine. It is hypothesized that these types of primitive anastomosearteries that fully belong to the intracranial arterial vascular system do not perform any supportivefunctional activity. Nevertheless, they undergo the normal biological decay caused by the aging processand metabolic dysfunctions. Therefore, such primitive fetal arteries as PTA might be subjected not onlyto a faster structural deterioration but they would actively contribute to a series of mechanisms causinga variety of idiopathic intracranial vascular and structural symptoms. Consequently, this would changethe primary therapeutic approach to solve this problem, today represented by surgical removal. Anatomicimplications related to treatment procedure are also discussed.
A SYSTEMATIC REVIEW ON PERSISTENT TRIGEMINAL ARTERY, IN SEARCHING FOR A THERAPEUTIC SOLUTION TO IDIOPATHIC AND UNRESPONSIVE TRIGEMINAL NERVE INFLAMMATIONS AND MIGRAINES
BALLINI, A.;
2019-01-01
Abstract
The rarely diagnosed persistent trigeminal artery (PTA) originates from the posterior bend or lateralwall of the intracavernous carotid artery and is the most common occurring type of remnant primitivefetal arteries. Even if PTA is uncommon, information and awareness about it could be of great help forclinicians dealing with cranial vascular imaging and operating this region. In addition, it could give asupporting response to the presence of a wide range of idiopathic and unresponsive disturbs that sometimesare erroneously interpreted and treated. There are very few published scientific reports of coexisting PTA and unilateral trigeminal neuralgia and migraine-cephalgia (MC). In this review we describe few reportedand unreported cases regarding the manifestation of unresponsive trigeminal neuralgia and migrainedue to the presence of PTA. Patients usually present with a clinical symptomatology with unstable bloodhypertension, pain of typical trigeminal neuralgia and MC that cover unilaterally the occipital area overthe second and third divisions of the nerve. The outbreaks may often become more severe during physicalexertion, stress and hypertension. Angio-MRI may reveal the PTA with an occasional occurrence of parietalcavernoma. We also describe a case of chronic left MC case associated with an adjacent PTA close to thewas safely treated by bio-identical testosterone, human placenta extract (HPE), b-nicotinamide adeninedinucleotide (NADH) and low dose amlopidine. It is hypothesized that these types of primitive anastomosearteries that fully belong to the intracranial arterial vascular system do not perform any supportivefunctional activity. Nevertheless, they undergo the normal biological decay caused by the aging processand metabolic dysfunctions. Therefore, such primitive fetal arteries as PTA might be subjected not onlyto a faster structural deterioration but they would actively contribute to a series of mechanisms causinga variety of idiopathic intracranial vascular and structural symptoms. Consequently, this would changethe primary therapeutic approach to solve this problem, today represented by surgical removal. Anatomicimplications related to treatment procedure are also discussed.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
