Hypoglossal artery: a review of normal and pathological features

Abstract

The hypoglossal artery is rarely described member of carotid-basilar family anastomoses. Together with a caudal end of the primitive internal artery, trigeminal, otic, and proatlantal intersegmental arteries, it represents the remnant of vascular channels' unsuccessful involution which function normally stops in human embryo with 12 to 14 mm crown-rump length. The persistence of hypoglossal artery alone is usually incidental and asymptomatic finding during the routine angiography, while during autopsies or surgical operations, its presence is frequently associated with other vascular or organic abnormalities and diseases. The aim of this review is to document the hypoglossal artery developmental morphology, as well as the normal anatomical and clinical aspects and better understanding of its persistence overall significance.

Persistent Fetal Intracranial Arteries

“…This plexus is supplied cranially by the primitive trigeminal artery and caudally by the primitive proatlantal intersegmental artery. Laterally, each longitudinal neural arterial plexus receives the primitive otic artery and primitive hypoglossal artery (Vasovic et al 2010). Usually, bilateral longitudinal neural arterial plexuses unite and form the basilar artery in the 7-12 mm crown-rump-length embryo (Padget 1948).…”

“…The hypoglossal artery is a rarely described member of the carotid-basilar family anastomoses (Vasovic et al 2008). It belongs to the group of segmental arteries, which establish dorsoventral anastomoses during early fetal life (Vlychou et al 2003).…”

“…Batujeff presented the first anatomical description of this vestigial vessel (Vasovic et al 2008). Murayama and colleagues reported the first case of bilateral persistent primitive hypoglossal arteries (Murayama et al 1985).…”

“…The author also described the diagnosis criteria of the variation (Memis and Guney 2001). The artery is situated dorsolaterally in the hypoglossal canal in relation to the rootlets of the hypoglossal nerve, or it pierces these rootlets when it is located in the subarachnoid space (Vasovic et al 2008).…”

“…It usually originates from the cervical portion of the internal carotid between the C1 and C2 vertebrae (Andoh et al 2001), from the C2 (Ahn et al 2005) or C3 vertebra level, or between C3 and C5 (Nishida et al 2000). There have also been reports about the persistent primitive hypoglossal artery as a terminal or dorsal branch of the internal carotid (Vasovic et al 2008), external carotid (Nakamura et al 2000), or right common carotid artery (Stern et al 1978).…”