Persistent Primitive Arteries

Abstract

Primitive anastomotic arteries temporarily exist between the future internal carotid and vertebrobasilar arteries during the early embryonic period(between 28 and 32 days of life). The primitive trigeminal, otic, hypoglossal, and proatlantal intersegmental arteries serve as major blood channels to the developing vertebrobasilar circulation at this stage. These arteries are replaced by the posterior communicating and vertebral arteries, and the primitive anastomotic arteries rapidly regress following the development of the definitive vertebrobasilar circulation. Occasionally, these primitive anastomoses persist and are incidentally discovered after birth. Physicians who treat cerebrovascular diseases should be familiar with the anatomy and functions of these vessels. In this review, we discuss the embryonic basis of the carotid-vertebrobasilar anastomoses and the clinical significance of their persistent forms in adults.