Unusual persistent primitive trigeminal artery with a superior duplicated basilar system

A 67-year-old patient who presented with a right cerebellar hemorrhage underwent vascular workup for suspicion of underlying vascular anomalies. A diagnostic cerebral angiogram demonstrated a duplicated basilar system fed solely by a persistent primitive trigeminal artery. The findings proved to be incidental and unrelated to the patient’s hemorrhage. These developmental abnormalities are consistent with embryological development.