Bilateral persistent primitive hypoglossal artery presenting with hemiplegia^✰

Area of Science:

• Neurovascular anatomy
• Vascular malformations
• Cerebral circulation

Background:

• Persistent carotid-vertebrobasilar anastomosis is a rare vascular anomaly.
• Bilateral persistent hypoglossal arteries (HAs) are exceptionally rare.
• Understanding these variations is crucial for neurovascular diagnostics.

Observation:

• A unique case of bilateral persistent HAs is presented.
• The hypoplastic vertebral arteries terminated into the posterior inferior cerebellar arteries.
• Detailed imaging (CT and MRI) findings of the anomaly's course and associations were analyzed.

Findings:

• The case demonstrates a rare variant of persistent hypoglossal arteries.
• Associated hypoplastic vertebral arteries showed an unusual termination pattern.
• A literature review of 6 similar bilateral HA cases provides context.

Implications:

• This case expands the understanding of rare cerebrovascular variations.
• Accurate identification through advanced imaging is vital for clinical management.
• Further research into the embryological basis of such anomalies is warranted.