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Variations of the cerebral arterial circle are frequently observed due to the progressively increasing utilization of diagnostic imaging techniques. Among these variations, the persistence of embryonic vessels, such as the persistent trigeminal artery (PTA), is rare yet holds significant clinical relevance. This presentation details a distinctive case of the PTA coexisting with a partial duplication of the anterior communicating artery (AComA), as identified through magnetic resonance angiography (MRA) in a 41-year-old female patient. The PTA was documented as a vessel linking the basilar artery to the cavernous segment of the left internal carotid artery. The AComA exhibited two branches emanating from the left anterior cerebral artery (LACA), which fused to form a single vessel that anastomosed with the right anterior cerebral artery (RACA). The coexistence of the PTA and AComA variant accentuates the imperative for clinicians to consider such rare anatomical configurations, mainly when performing procedures in proximity to the gasserian ganglion, cavernous sinus, or anterior circulation. The application of three-dimensional imaging remains vital for ensuring precise diagnosis and effective treatment planning.
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http://dx.doi.org/10.1007/s00276-025-03687-9 | DOI Listing |
Cureus
August 2025
Neurosurgery-Gamma Knife Program, International Cancer Center, Diagnostic Hospital, San Salvador, SLV.
Stereotactic radiosurgery (SRS), a noninvasive technique that delivers a high dose of ionizing radiation to a precisely defined focal target volume, is foundational to modern neuro-oncology and functional neurosurgery. SRS provides highly accurate, noninvasive treatment for a range of intracranial conditions, including malignant and benign tumors, vascular malformations such as arteriovenous malformations (AVMs), and movement or functional disorders like trigeminal neuralgia. Despite a well-documented safety record and demonstrable efficacy, significant disparities in accessibility persist across global, geographic, and socioeconomic lines.
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July 2025
Oral Surgery, Kansai Medical University Medical Center, Moriguchi, JPN.
Diffuse sclerosing osteomyelitis (DSO) is a rare, chronic aseptic osteomyelitis of the mandible characterized by resistance to conventional therapies including nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, corticosteroids, and surgery. Diagnosis is often delayed due to nonspecific symptoms and lack of typical infectious signs, sometimes resulting in misdiagnosis. We report a case of a 58-year-old male patient with persistent mandibular pain initially misdiagnosed as trigeminal neuralgia and treated with microvascular decompression surgery without improvement.
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August 2025
Department of Ophthalmology, Hokkaido University, Sapporo, JPN.
Blepharospasm, characterized by abnormal blinking and sensory hypersensitivity such as photophobia and ocular pain, is thought to arise from pathological sensorimotor integration. We report a rare case of a male teenager with a growth hormone-secreting giant pituitary adenoma compressing both the optic chiasm and bilateral trigeminal nerves. Initially, the patient presented with visual disturbances and bitemporal hemianopia, without photophobia or ocular pain.
View Article and Find Full Text PDFNeurosurg Focus
September 2025
1Department of Neurosurgery, Queen's Hospital Romford, Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, United Kingdom.
Objective: This study aimed to compare pain outcomes and complication rates between reexploration microvascular decompression (MVD), percutaneous rhizotomy (PR), and stereotactic radiosurgery (SRS) as second-line treatments for recurrent or persistent trigeminal neuralgia (TN) following an initial MVD.
Methods: A systematic review and meta-analysis was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines. Studies were included if they reported outcomes of reexploration MVD, PR, or SRS in adult patients with classic or idiopathic TN after a failed initial MVD.
Clin Neuroradiol
August 2025
Department of Neurology, WellStar Medical College of Georgia, Augusta University, 1120 15th Street, 30912, Augusta, GA, USA.