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Endarterectomy for persistent primitive hypoglossal artery--case report.

I Sunada1, S Yamamoto, Y Matsuoka

  • 1Department of Neurosurgery, Yamamoto Daisan Hospital, Osaka.

Neurologia Medico-Chirurgica
|February 1, 1991
PubMed
Summary

Persistent primitive hypoglossal artery, a rare carotid artery to vertebrobasilar system connection, can cause stroke. Surgical intervention for stenosis in this artery led to a rare complication of Pseudomonas aeruginosa infection causing carotid artery rupture.

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Area of Science:

  • Vascular Neurology
  • Cerebrovascular Anatomy

Background:

  • Persistent primitive hypoglossal artery (PPHA) is a rare vascular anomaly connecting the internal carotid artery (ICA) to the vertebrobasilar system.
  • While often asymptomatic, PPHA can be associated with ischemic cerebrovascular events.

Observation:

  • A 62-year-old male presented with left hemiparesis due to a PPHA with significant stenosis at its origin from the ICA.
  • The PPHA supplied a substantial portion of the vertebrobasilar circulation.

Findings:

  • Surgical endarterectomy of the ICA and PPHA was performed.
  • A delayed complication of Pseudomonas aeruginosa infection led to a rupture of the ICA at the surgical site, requiring re-suture.
  • This represents the second reported case of PPHA endarterectomy.

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Implications:

  • Infection is a critical complication following endarterectomy of PPHA, potentially leading to catastrophic hemorrhage.
  • This case highlights the importance of considering infectious etiologies in delayed post-operative vascular complications.
  • Further research into managing PPHA-related stenosis and its surgical risks is warranted.