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Case Reports
. 2016 May 31;2(2):20150301.
doi: 10.1259/bjrcr.20150301. eCollection 2016.

Persistent hypoglossal arteries with aneurysmal dilation of left hypoglossal artery: a rare case report and review of the literature

Shaileshkumar Garge  1 , Vinu Moses  1 , Shyamkumar Keshava  1 , Munawwar Ahmed  1 , Ranjit Moorthy  1
Affiliations
Case Reports

Persistent hypoglossal arteries with aneurysmal dilation of left hypoglossal artery: a rare case report and review of the literature

Shaileshkumar Garge et al. BJR Case Rep. .

Abstract

Persistence of foetal anastomoses between carotid and vertebrobasilar arteries is a well-known anomaly, although bilateral persistence of these anastomoses is uncommon. Persistent hypoglossal artery is one of the four anastomotic vessels between the carotid and the vertebrobasilar arterial systems. Persistence of bilateral hypoglossal arteries with other associated anomalies is exceptionally uncommon and may result in unusual symptoms or have implications for therapy. We report an incidentally detected case of bilateral persistent hypoglossal arteries with an associated finding of hypoplastic vertebral arteries, describe their embryology and consider the potential clinical implications of this finding.

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Figures

Figure 1.
Figure 1.
CT scan of the brain at the level of the mid-brain showing hyperdense blood in the perimesencephalic cistern on the left side (arrow).
Figure 2.
Figure 2.
Left vertebral artery digital subtraction angiography, lateral projection (a) and Towne’s projection (b), showing the persistent hypoglossal artery that arose from the cervical segment of the internal carotid artery apparently followed the normal course of vertebral arteries and then took a slight dorsal course to enter the cranium via the hypoglossal canal before joining the proximal basilar artery (arrows) with an associated fusiform aneurysmal dilation of the segment towards the basilar artery (open arrows) and the mildly hypoplastic vertebral artery (thick arrow).
Figure 3.
Figure 3.
Right vertebral artery digital subtraction angiography, lateral projection (native image for bony landmarks) showing a hypoglossal artery similar to the left side but without any dilation (arrow). Hypoplastic vertebral artery is noted (thick arrow).
Figure 4.
Figure 4.
MR angiography maximum intensity projection images, axial (a) and sagittal (b), showing bilateral persistent hypoglossal arteries with aneurysmal dilation on the left hypoglossal artery (arrows).
See this image and copyright information in PMC

References

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