A persistent primitive hypoglossal artery-posterior inferior cerebellar artery convergence aneurysm treated by stent-assisted coil embolization

Zeng, Shi; Yang, Donghong; Yang, Haitang; Xu, Lunshan; Xu, Minhui

doi:10.1097/md.0000000000017151

Cited by 3 publications

(12 citation statements)

References 15 publications

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“…Nevertheless, in the presence of a PPHA, the probability of an aneurysm to occur rises to about 26% [10,11] . The PPHA often triggers changes in the hemodynamics of the carotid as well as vertebrobasilar arteries resulting in the formation of the aneurysms [4,12,13] . PPHAs are commonly seen in women as compared with men and they often occurs on the left side [4,6,14] .…”

Section: Discussionmentioning

confidence: 99%

“…[10,11] The PPHA often triggers changes in the hemodynamics of the carotid as well as vertebrobasilar arteries resulting in the formation of the aneurysms. [4,12,13] PPHAs are commonly seen in women as compared with men and they often occurs on the left side. [4,6,14] PPHAs often originate from the ICA, external carotid artery, or both sides.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical evaluation as well as clipping of the aneurysms on the parent PPHA in the posterior circulation is often very difficult [9] . Thus, endovascular coiling is the currently the safest and easier treatment option for acutely ruptured intracranial arterial aneurysms with decreased morbidity as well as morbidity in complex PPHA harboring aneurysms as compared with open surgery [3–9] . We report a rare case of a fenestrated PPHA harboring a ruptured aneurysm which we successfully treated with stent-assisted coil embolization.…”

Section: Introductionmentioning

confidence: 99%

“…Persistent primitive hypoglossal artery (PPHA) is a rare and permanent carotid-vertebrobasilar anastomoses with an incidence rate of about 0.02% to 0.26% [1–3] . The PPHA mostly originates from the internal carotid artery (ICA) and rarely from the external carotid artery [4] . Patients with PPHA usually have higher changes of developing intracranial aneurysms due the high intracranial hemodynamics [5–8] .…”

Section: Introductionmentioning

confidence: 99%

“…[9] Thus, endovascular coiling is the currently the safest and easier treatment option for acutely ruptured intracranial arterial aneurysms with decreased morbidity as well as morbidity in complex PPHA harboring aneurysms as compared with open surgery. [3][4][5][6][7][8][9] We report a rare case of a fenestrated PPHA harboring a ruptured aneurysm which we successfully treated with stent-assisted coil embolization. Although cases of PPHA alone and PHHA with aneurysms have been reported in literature, cases of fenestrated PPHA harboring a ruptured aneurysm have seldomly be reported in literature.…”

Section: Introductionmentioning

confidence: 99%

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A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm

Wei

Xie

et al. 2021

Medicine

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Rationale:Persistent primitive hypoglossal artery (PPHA) is a rare and permanent carotid-vertebrobasilar anastomoses. Patients with PPHA usually have higher changes of developing intracranial aneurysms due the high intracranial hemodynamics. Although cases of PPHA alone and PPHA with aneurysms have been reported in literature, cases of fenestrated PPHA harboring a ruptured aneurysm have seldomly be reported in literature. We present a rare occurrence of a fenestrated PPHA harboring a reputed aneurysm.Patients concerns:A 43-year-old woman was presented with a sudden-onset severe headache and nausea.Diagnosis:Computerized tomography scan showed third, fourth, and bilateral ventricular hemorrhages. Computed tomographic angiogram showed a PPHA with fenestration malformation and a cystic protrusion consistent with an aneurysm.Intervention:The patient underwent a successful stent-assisted coil embolization via the trans-arterial route under general anesthesia.Outcomes:Two years follow-up revealed no recurrence of her symptomatology and she is currently well and go about her normal daily life.Conclusion:Fenestrated PPHAs harboring aneurysms may be more prone to rupture because of the fenestration and connective tissue weakness of the artery as well as changes in hemodynamics of the already malformed and weak artery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm

Wei

Xie

et al. 2021

Medicine

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Concurrence of multiple aneurysms, extreme coiling of the extracranial internal carotid artery and ipsilateral persistent primitive hypoglossal artery: A case report and literature review

Wan

Liu

et al. 2022

Front. Neurol.

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BackgroundThe primitive hypoglossal artery (PHA) is an anastomotic vessel of the carotid-basilar artery system that is prevalent only transiently during the embryonic period. Persistent primitive hypoglossal artery (PPHA) is a rare vessel variation in which PHA exists persistently in adulthood and occurs in approximately 0.02–0.1% of the population. Tortuosity of the extracranial internal carotid artery (ICA) is relatively common, impacting 10–43% of the population, and is caused by either congenital or acquired factors. It is still unknown whether PPHA and tortuosity of extracranial ICA are associated. Here, we present a case report of the concurrence of three types of pathologies of the carotid artery: extreme coiling of the extracranial internal carotid artery, multiple aneurysms and persistent primitive hypoglossal artery.Case descriptionA 66-year-old woman suffered intermittent headaches, dizziness and numbness of the right eyelid for 5 years. Magnetic resonance angiography performed in a local hospital reported an aneurysm of the posterior communicating artery segment of the left ICA and a left PPHA. Digital subtraction angiography conducted after admission showed a PPHA originating from the left cervical ICA and an extremely coiling segment of the ICA distal to the beginning of PPHA. Except for the aneurysm of the posterior communicating artery segment of the left ICA, multiple aneurysms were found at the coiling segment of the ICA.ConclusionTo the best of our knowledge, this is the first report of PPHA accompanied by an adjacent, extremely coiling ICA. There are no reports of similar tortuous ICAs to this extent or at this position. Including aneurysms, three types of pathologies suggest their congenital origin, and a review of the literature infers the probable association of these lesions.

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Peculiar Neurological Examination Secondary to Persistent Primitive Hypoglossal Artery

Hamzoian,

Harris,

Ditamo

et al. 2023

Cureus

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A persistent primitive hypoglossal artery (PPHA) is an anatomical variant resulting in persistent carotid-vertebrobasilar anastomoses. This variant arises from the distal cervical segment of the internal carotid artery (ICA) between C1 and C3 and passes through an enlarged hypoglossal canal to join the basilar circulation. This case report describes a 60-year-old male with an acute ischemic event secondary to an occlusion in the right ICA and PPHA, resulting in a unique physical examination. Digital subtraction angiography (DSA) was utilized to visualize occlusion of the right common carotid artery with no residual right internal carotid artery or right vertebral artery filling. The patient's presenting symptoms yielded a unique neurological examination, making it difficult to localize a solitary lesion, which would account for the patient’s acute presentation. In retrospect, with angiography revealing a right PPHA, his presentation fit more thoroughly with the clinical picture. With the increased utility of neuro-endovascular procedures, clinicians have a higher probability of encountering diverse angiographical findings. With this case report, we would like to familiarize practitioners with the presence of PPHA, present unique imaging findings involving typically isolated vascular territories, and stress the importance of clinical judgment when making decisions regarding stroke care.

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A persistent primitive hypoglossal artery-posterior inferior cerebellar artery convergence aneurysm treated by stent-assisted coil embolization

Cited by 3 publications

References 15 publications

A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm

A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm

Concurrence of multiple aneurysms, extreme coiling of the extracranial internal carotid artery and ipsilateral persistent primitive hypoglossal artery: A case report and literature review

Peculiar Neurological Examination Secondary to Persistent Primitive Hypoglossal Artery

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