Posterior Inferior Cerebellar Artery Thrombosed Aneurysm Associated with Persistent Primitive Hypoglossal Artery Successfully Treated with Condylar Fossa Approach

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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Variant of a persistent hypoglossal artery supplying only the posterior inferior cerebellar artery diagnosed by magnetic resonance angiography: a case report

Surgical and Radiologic Anatomy ◽

10.1007/s00276-018-1970-z ◽

2018 ◽

Vol 40 (7) ◽

pp. 807-810 ◽

Cited By ~ 2

Author(s):

Akira Uchino ◽

Chihiro Suzuki

Keyword(s):

Case Report ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Posterior Inferior Cerebellar Artery ◽

Persistent Hypoglossal Artery ◽

Hypoglossal Artery ◽

Cerebellar Artery

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Republished: Basilar stroke from a persistent hypoglossal artery

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2016-012859.rep ◽

2017 ◽

Vol 9 (8) ◽

pp. e30-e30 ◽

Cited By ~ 3

Author(s):

Alfred P See ◽

Jacob F Baranoski ◽

Bruno C Flores ◽

Andrew Ducruet ◽

Felipe C Albuquerque

Keyword(s):

Posterior Inferior Cerebellar Artery ◽

Left Vertebral Artery ◽

Cross Sectional ◽

Persistent Hypoglossal Artery ◽

Arterial Access ◽

Hypoglossal Artery ◽

Left Posterior ◽

Cerebellar Artery ◽

Cross Sectional Imaging ◽

Basilar Occlusion

Occlusion of the basilar artery can be treated with endovascular thrombectomy, although the results have not been well studied. Persistent fetal cerebrovascular anatomy can lead to unusual presentation of carotid atherosclerotic disease and can be a barrier to successful mechanical thrombectomy if not recognized. This case presents a rare persistent carotico–basilar anastomosis which resulted in basilar occlusion via the persistent hypoglossal artery and coincident absence of contralateral vertebral arterial access due to a left vertebral artery terminating in the left posterior inferior cerebellar artery. Preoperative recognition of this anatomy afforded by review of cross-sectional imaging was critical to success during this emergent procedure.

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Variation of a Persistent Primitive Hypoglossal Artery (PPHA) as Incidental Finding in the Diagnostic Clarification of Cerebral Vasculopathy Associated with Intracranial Vasculitis

International Journal of Angiology ◽

10.1055/s-0035-1568879 ◽

2015 ◽

Vol 26 (02) ◽

pp. 121-124

Author(s):

L. Marques ◽

M. Preiß ◽

W. Börm ◽

S. Müller-Hülsbeck ◽

S. Hopf-Jensen

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Vertebral Artery ◽

Internal Carotid ◽

Incidental Finding ◽

Posterior Inferior Cerebellar Artery ◽

Left Frontal Lobe ◽

Hypoglossal Artery ◽

Persistent Primitive Hypoglossal Artery ◽

The Right

AbstractWe present a very rare variation of a persistent primitive hypoglossal artery (PPHA) arising from the internal carotid artery, detected during a diagnostic angiography. A 50-year-old female patient was admitted with an atypical intracranial hematoma in the left frontal lobe. Catheter angiography revealed intracranial vasculopathy with segmental stenoses, a small aneurysm of the right internal carotid artery bifurcation and a “string of beads” appearance of the left carotid artery, consistent with fibromuscular disease. On the left side, a vertebral artery ending in the posterior inferior cerebellar artery (PICA) was detected, whereas on the right side the vertebral artery was aplastic. During selective angiography of the right common carotid artery, a persistent hypoglossal artery was seen supplying the basilar artery. The literature of persistent embryonal carotid-vertebrobasilar anastomosis and their anatomical variations is discussed with respect to clinical importance for ischemia, interventional procedures, and surgery.

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Endovascular treatment of AVM-associated aneurysm of anterior inferior cerebellar artery through persistent primitive hypoglossal artery

British Journal of Neurosurgery ◽

10.3109/02688697.2011.584983 ◽

2011 ◽

Vol 26 (1) ◽

pp. 86-88 ◽

Cited By ~ 3

Author(s):

Goran Pavlisa ◽

Marko Rados ◽

David Ozretic ◽

Gordana Pavlisa

Keyword(s):

Endovascular Treatment ◽

Anterior Inferior Cerebellar Artery ◽

Hypoglossal Artery ◽

Cerebellar Artery ◽

Persistent Primitive Hypoglossal Artery

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Persistent Hypoglossal Artery Associated with a Ruptured Ipsilateral Posterior Inferior Cerebellar Artery Aneurysm

The Neuroradiology Journal ◽

10.1177/197140090702000516 ◽

2007 ◽

Vol 20 (5) ◽

pp. 570-573 ◽

Cited By ~ 1

Author(s):

E. Uysal ◽

M. Velioglu ◽

E. Kara ◽

S. Albayram ◽

C. Islak ◽

...

Keyword(s):

Rare Case ◽

Posterior Inferior Cerebellar Artery ◽

Artery Aneurysm ◽

Ruptured Aneurysm ◽

Persistent Hypoglossal Artery ◽

Hypoglossal Artery ◽

Endovascular Occlusion ◽

Cerebellar Artery

A rare case of persistent hypoglossal artery in conjuction with a ruptured aneurysm at the left proximal posterior inferior cerebellar artery (PICA) is presented. A ruptured PICA aneurysm was successfully treated by endovascular occlusion of the aneurym with coiling.

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