永存三叉动脉合并缺血性卒中1例报道A Case Report of Ischemic Stroke Complicated with Persistent Trigeminal Artery

永存三叉动脉（persistent trigeminal artery，PTA）是一种连接颈内动脉系统与椎基底动脉系统的血管变异，临床报道相对较少。本文报道1例合并PTA的缺血性卒中病例。该患者以多发脑梗死为特点，且同时累及前后循环，病因类型为大动脉粥样硬化型，发病机制考虑为动脉-动脉栓塞。患者发病时以突发行走不稳及言语障碍为主要表现，症状持续未缓解；查体可见神经功能缺损，影像学检查提示右侧颈内动脉系统及椎基底动脉系统多发急性脑梗死灶；血管相关检查显示颅内外多发动脉粥样硬化性改变，右侧颈内动脉存在狭窄及溃疡斑块，同时合并PTA血管变异。经综合评估，予患者阿司匹林联合替格瑞洛双联抗血小板治疗及强化降脂、稳定斑块治疗。患者出院后随访显示症状改善，相关实验室指标达标。Persistent trigeminal artery (PTA) is a vascular variation connecting the internal carotid artery system and the vertebrobasilar artery system, with relatively few clinical reports. This paper presents a case of ischemic stroke complicated with PTA. The patient was characterized by multiple infarction, involving both the anterior and posterior circulations, with the etiological type identified as large artery atherosclerosis, and the pathogenesis considered to be artery-to-artery embolism. At onset, the patient presented with sudden gait instability and speech disturbance, which persisted without remission. Neurological deficits were observed on physical examination. Imaging examinations revealed multiple acute infarcts in the right internal carotid artery system and the vertebrobasilar artery system. Vascular-related examinations showed multiple intracranial and extracranial atherosclerotic changes, with stenosis and ulcerated plaque in the right internal carotid artery, combined with PTA vascular variation. After comprehensive evaluation, the patient was treated with dual antiplatelet therapy with aspirin plus ticagrelor, intensive lipid-lowering therapy, and plaque stabilization therapy. Follow-up after discharge showed improvement in symptoms and achievement of target values for relevant laboratory indicators.