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Updated: May 9, 2026

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging (MRI)
Published on: December 16, 2021
A persistent primitive hypoglossal artery arising from the external carotid artery associated with subarachnoid
Shuhan He1, Jonathan J Russin1, Peter Adamczyk1
1Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Background:
A persistent primitive hypoglossal artery (PHA) is a rare congenital caroticobasilar anastomosis with a reported prevalence of 0.027%-0.26%. Intracranial aneurysms occur with a frequency of approximately 26% in the setting of PHAs.
Case Description:
PHAs typically originate from the proximal cervical internal carotid artery. To date, however, six cases of PHAs originating from the external carotid artery have been reported. We present the first case of a PHA originating from the external carotid artery associated with subarachnoid hemorrhage.
Conclusion:
We review the literature and discuss anatomic implications with respect to the extreme lateral infrajugular transcondylar exposure for clip ligation of a ruptured posterior inferior cerebellar artery aneurysm in the setting of a PHA.
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