Cerebellar haemorrhage associated with persistent primitive trigeminal artery

Abstract

A 55-year-old woman was admitted to our hospital because of sudden onset of dizziness and gait ataxia. A brain CT scan revealed a small cerebellar haemorrhage located in the right vermis. Brain MR angiography revealed left persistent primitive trigeminal artery (PPTA) and basilar artery (BA) dysplasia proximal to the shunting PPTA without arteriovenous malformation (AVM) or aneurysm. We speculate that BA dysplasia due to the PPTA, along with poorly controlled hypertension resulted in overload of the superior cerebellar artery blood vessels through the PPTA, leading to a haemorrhage in the right vermis. BA dysplasia and a PPTA without an obvious AVM or aneurysm possibly leading to cerebellar haemorrhage is rare. PPTA is a relatively common vascular anomaly; hence, we must consider it in the differential diagnosis for brain haemorrhages that may be caused by the specific haemodynamic consequences of PPTA.