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[Ruptured persistent primitive hypoglossal artery aneurysm: case report].

A Sawamura1, H Kamiyama, N Kobayashi

  • 1Department of Neurosurgery, Asahikawa Red Cross Hospital, Japan.

No Shinkei Geka. Neurological Surgery
|August 10, 1999
PubMed
Summary

Persistent primitive hypoglossal artery, a rare vascular variation, can lead to aneurysms. This case highlights a ruptured aneurysm in a patient with this anomaly, successfully treated.

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Area of Science:

  • Vascular Neurology
  • Neuroanatomy
  • Interventional Neuroradiology

Background:

  • Persistent primitive hypoglossal artery (PPHA) is a rare congenital vascular anomaly originating from the internal carotid artery.
  • It connects to the basilar artery via the hypoglossal canal, and its presence is often suspected with canal enlargement.

Observation:

  • A 66-year-old male presented with subarachnoid hemorrhage (SAH) due to a ruptured PPHA aneurysm.
  • Associated findings included absence of the posterior communicating artery and hypoplasia of the contralateral vertebral artery.
  • Intraoperative re-rupture occurred during surgical clipping via a transcondylar approach.

Findings:

  • The ruptured PPHA aneurysm was partially clipped, and the patient experienced transient lower cranial nerve palsy.

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  • Follow-up angiography showed no vasospasm, and the patient was discharged without neurological deficits after treatment for hydrocephalus.

    • Implications:

    • This case underscores the importance of recognizing PPHA as a potential source of intracranial aneurysms.
    • Management of PPHA aneurysms can be challenging due to anatomical variations and potential intraoperative complications.
    • Early diagnosis and appropriate surgical or endovascular intervention are crucial for favorable outcomes.