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Summary
A rare persistent hypoglossal artery aneurysm, associated with two other aneurysms, was surgically treated. Direct surgical intervention is crucial for these brainstem-supplying artery aneurysms.
Area of Science:
- Vascular Neurology
- Cerebrovascular Surgery
- Embryology
Background:
- The persistent hypoglossal artery is an embryonic anastomosis between the carotid and basilar arterial systems.
- It is a complex vessel, often incorporating elements of the vertebrobasilar system.
Observation:
- This report details the sixth case of a persistent hypoglossal artery aneurysm.
- This specific case is unique due to its association with two supratentorial aneurysms, one of which had ruptured.
Findings:
- All three aneurysms were successfully treated via a direct surgical approach.
- Persistent hypoglossal artery aneurysms typically occur at the junction with the basilar artery.
- These aneurysms are often located in the subarachnoid space, compressing the brainstem.
Implications:
- Direct surgical treatment is necessary as the parent artery cannot be ligated due to its critical role in brainstem supply.
- Surgical access is typically achieved through a suboccipital craniectomy.
- Understanding the embryological origin and anatomical variations is key for managing these rare cerebrovascular conditions.