# Incidental Finding of Persistent Trigeminal Artery in a Young Woman: A Case Report

## TL;DR

A young woman with a persistent headache had an incidental discovery of a rare blood vessel malformation called a persistent trigeminal artery during an MRI scan.

## Contribution

This case report highlights the incidental detection of a persistent trigeminal artery in a young woman with unexplained headaches.

## Key findings

- The persistent trigeminal artery was identified via magnetic resonance angiography (MRA).
- The patient experienced persistent headaches without a clear cause or improvement with medication.
- The finding was incidental and not associated with specific neurological symptoms at the time of diagnosis.

## Abstract

Persistent trigeminal artery disease is one of the most common types of persistent carotid-vertebrobasilar anastomoses. Usually, it is unilateral, and it can be discovered with a magnetic resonance angiography (MRA), computed tomography angiography (angioCT), or classic angiography exam. It can be associated with non-specific symptoms, such as headaches, or more specific ones, such as III or VI nerve palsy or trigeminal neuralgia, but most of the time it goes undetected, being an incidental finding and not causing any symptoms. On MRA and angioCT, it has the characteristic “tau” sign. We present the case of a young woman who, incidentally, discovered this malformation after undergoing an MRA. She had been experiencing a persistent headache without a known cause, which did not improve despite medication.