# Ruptured Anterior Inferior Cerebellar Artery Aneurysm From a Persistent Trigeminal Artery: A Case Report

## TL;DR

This case report describes a rare aneurysm in the anterior inferior cerebellar artery caused by a persistent trigeminal artery, highlighting treatment challenges.

## Contribution

The paper presents the first reported case of an aneurysm in the anterior inferior cerebellar artery associated with a persistent trigeminal artery.

## Key findings

- Aneurysms associated with persistent trigeminal arteries can occur in the posterior circulation, specifically the anterior inferior cerebellar artery.
- Such cases complicate endovascular treatment due to altered blood flow and increased vessel tortuosity.

## Abstract

Persistent trigeminal artery (PTA) is the most common remnant of the primitive carotid-vertebrobasilar anastomoses, which typically form and obliterate during the early stages of human embryonic development. While PTA can be non-pathologic and is usually an incidental finding, it is also associated with various other vascular abnormalities, such as arteriovenous malformations and fistulae, but most commonly cerebral aneurysms. In these cases, aneurysms are usually reported in the anterior cerebral circulation or in the PTA trunk itself; to date, only one report exists of an associated aneurysm in the posterior circulation (basilar artery). These associated vascular pathologies are not only a source of morbidity and mortality but can also complicate subsequent endovascular treatment due to different flow patterns and increased vessel tortuosity. In this case report, we present the first reported case of PTA-associated aneurysm in the anterior inferior cerebellar artery and its resulting impact on the endovascular treatment of this aneurysm.