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May 1962

Recurrent Oculomotor Paresis: Paresis Associated with a Vascular Anomaly, Carotid-Basilar Anastomosis

Author Affiliations

From the Division of Neurology, Montefiore Hospital, New York 67, and the Department of Neurology, College of Physicians and Surgeons, Columbia University.

Arch Neurol. 1962;6(5):353-357. doi:10.1001/archneur.1962.00450230015002

The persistence of the primitive trigeminal artery forming a carotid-basilar anastomosis is a fairly rare occurrence. There have been only 22 cases found at autopsy in the literature; 43 have been demonstrated by angiography. This report is the first, to our knowledge, in which the patient had an oculomotor paralysis associated with the presence of this arterial anomaly.

In the 20-somite (3 mm., or 26 day) human embryo, the longitudinal neural arterial plexus receives its major blood supply from the primitive trigeminal artery, a branch of the internal carotid artery which develops intimately with the gasserian ganglion; the ganglion is quite prominent at this stage. As development of the embryo continues, the longitudal neural vascular plexus organizes into the basilar artery. At the 14 mm. (45-day) stage of the embryo, the carotid-basilar anastomosis is normally obliterated (Padget)1; it is replaced by the posterior communicating artery and ultimately by the

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