Persistent hypoglossal artery with hypoplasia of the vertebral and posterior communicating arteries

Abstract

We observed a rare case of the right persistent hypoglossal artery (PHA) in the posterior cranial fossa of a deceased 74-year-old Japanese man who did not have any clinical manifestations related to this anomaly when alive. The large-sized PHA originating from the cervical internal carotid artery passed through the hypoglossal canal together with the hypoglossal nerve and reached the posterior cranial fossa to anastomose the basilar artery. In addition, the ipsilateral vertebral artery and bilateral posterior communicating arteries were hypoplastic. Here, we discuss the developmental mechanisms underlying the formation of the PHA and the spectrum of diseases related to its presence.

Endarterectomy of carotid artery bifurcation in the setting of a persistent hypoglossal artery and anomalous collateral vascular supply

“… 5 These findings have been noted by previous authors as complicating carotid endarterectomy in the context of a persistent HGA. 7 , 8 …”

Bilateral type IIpersistent proatlantal intersegmental artery: a rare variant of persistent carotid-vertebrobasilar anastomoses

“… 14,15 Therefore, it is commonly associated with paroxysmal vertigo, disturbance of consciousness or cross-paralysis and other symptoms of ischaemic cerebrovascular diseases. 16 The PIA may be accompanied by other cerebrovascular abnormalities or malformations, such as hypoplasia of ICA and ECA, internal carotid-cavernous fistula, VA hypoplasia, intracranial arteriovenous malformation, intracranial aneurysm. Choudhary G analysed 21 cases of the type II PIA and found that most of them were complicated with cerebral vascular abnormalities and two cases were accompanied by aneurysms 1.…”

Persistent hypoglossal artery with a contralateral hypoglossal canal venous lake: a case report

“…Exposure of the basilar trunk to an unusual haemodynamic stress could be the underlying mechanism that predisposes an individual to the development of aneurysms. 4 On the contrary, there is an increased risk of ischaemia caused by embolism from the internal carotid artery to the posterior circulation through the PHA. 5 Both vascular anomalies in this patient were most likely incidental findings; however, owing to the reported association of PHA with intracranial aneurysm development and ischaemic events, any new episode or the development of neurological symptoms should have triggered immediate imaging study.…”