Successful Operative Treatment of an Aneurysm on a Left Persistent Hypoglossal Artery

Eb, Bongartz; He, Nau; Grote, W.

doi:10.1055/s-0028-1090373

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…Following inclusive wide-ranging literature search, over 700 abstracts were included for analysis (Figure 3), after review 24 articles were included for the qualitative study (Tables 1 and 2). 8–30 In total, 24 aneurysms (25 including this study) have been treated in relation to a PHA, 18 have been with surgery and six (seven including this study) with endovascular therapy. The majority of these aneurysms are reported to have occurred at the hypoglossal-basilar artery junction whilst six (seven including this study) have specified an aneurysm relating to the PICA origin.…”

Section: Systematic Reviewmentioning

confidence: 99%

Persistent hypoglossal artery aneurysm: Case report and qualitative systematic review

et al. 2018

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A persistent hypoglossal artery was first described in 1889 and is one of the more common anatomical variations arising from aberration in normal development. Endovascular coiling has been recognised as a robust treatment for acutely ruptured intracranial arterial aneurysms, although specific data regarding an aneurysm arising from a persistent hypoglossal artery is lacking due to the low incidence. Here we report both the oldest patient reported to be treated with a persistent hypoglossal artery-associated aneurysm and also explicitly report endovascular treatment of a persistent hypoglossal artery aneurysm arising at the posterior inferior cerebellar artery origin. Qualitative systematic review of the available medical literature demonstrates limited evidence regarding treatment of persistent hypoglossal artery-associated aneurysms with the majority being carried out via open surgery. Ruptured posterior inferior cerebellar artery aneurysm arising from a persistent hypoglossal artery can be successfully and safely treated by endovascular therapy via the persistent hypoglossal artery. Randomised study of this situation is unlikely to be feasible; however, qualitative review of the literature reveals six such aneurysms that have been treated surgically, and this case appears to be the first via an endovascular means.

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Section: Systematic Reviewmentioning

confidence: 99%

Persistent hypoglossal artery aneurysm: Case report and qualitative systematic review

et al. 2018

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“…Surgical treatment via either wrapping or clipping of the aneurysm was the initial treatment for PPHA with aneurysms [20,21] . However, surgical approach is always challenging for these aneurysms in the posterior circulation [9] .…”

Section: Discussionmentioning

confidence: 99%

“…[9,19] Surgical treatment via either wrapping or clipping of the aneurysm was the initial treatment for PPHA with aneurysms. [20,21] However, surgical approach is always challenging for these aneurysms in the posterior circulation. [9] Surgical unreachability, unsuccessfulness of clipping, wide or absent aneurysm neck, and a medical illness impeding craniotomy were the initial potential indications of endovascular intervention for the treatment of PPHA.…”

Section: Discussionmentioning

confidence: 99%

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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“…Almost all aneurysms located on the PPHA were treated surgically by either clipping or wrapping. [7,8–10] However, a surgical approach for these aneurysms, as for other aneurysms in the posterior circulation, is always challenging, while the posterior circulation is exclusively fed by the PPHA confers additional risk to the treatment.…”

Section: Discussionmentioning

confidence: 99%

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

Zeng

Yang

et al. 2019

Medicine

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Rationale:Persistent primitive hypoglossal artery (PPHA) is often associated with intracranial anomalies such as aneurysms. Surgical treatment of aneurysms on the PPHA is challenging due to that the posterior circulation depends solely on PPHA.Patient concerns:A case of an 83-year-old woman with a large aneurysm on PPHA presented with vertigo was reported.Diagnosis:Three-dimensional angiogram revealed a wide-neck aneurysm on the PPHA.Interventions:The aneurysm was successfully treated using a novel low-profile visualized intraluminal support stent-assisted coiling technique.Outcomes:No complications occurred during the procedure. The final angiogram confirmed the patency of the posterior inferior cerebellar artery and the parent artery and its distal branches.Lessons:Our case suggests that stent-assisted coil embolization is safe and effective for the treatment of aneurysms on the PPHA.

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Successful Operative Treatment of an Aneurysm on a Left Persistent Hypoglossal Artery

Cited by 11 publications

References 9 publications

Persistent hypoglossal artery aneurysm: Case report and qualitative systematic review

Persistent hypoglossal artery aneurysm: Case report and qualitative systematic review

A fenestrated persistent primitive hypoglossal artery harboring a ruptured aneurysm

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

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