Persistent hypoglossal artery associated with basilar artery aneurysm

Area of Science:

• Neurology
• Vascular Anatomy
• Neurosurgery

Background:

• Persistent hypoglossal artery is a rare congenital anomaly where the hypoglossal nerve's vascular supply arises from the carotid artery instead of the vertebral artery.
• Basilar artery aneurysms, particularly at the bifurcation, are significant cerebrovascular pathologies.

Observation:

• A saccular aneurysm was identified at the tip of the basilar artery.
• The patient presented with a persistent hypoglossal artery originating from the left internal carotid artery.
• Bilateral absence of the vertebral arteries and posterior communicating arteries was noted.

Findings:

• This case highlights an extremely rare co-occurrence of a persistent hypoglossal artery and a basilar bifurcation aneurysm.
• The described vascular anatomy represents a unique variation in cerebral circulation.

Implications:

• Understanding this rare anatomical configuration is crucial for neurosurgeons planning interventions for basilar artery aneurysms.
• This case underscores the importance of detailed vascular imaging in patients with congenital anomalies.
• Management strategies may need to be tailored due to the atypical collateral circulation pathways.