[Persistent primitive hypoglossal artery associated with intracranial aneurysm (author's transl)]

A case of the persistent left primitive hypoglossal artery associated with an intracranial aneurysm was reported. The thirty-year-old man was admitted to hospital in the diagnosis of subarachnoid hemorrhage at seven days after the onset. Bilateral carotid angiograms revealed a saccular aneurysm at the right internal carotid-posterior communicating artery junction and a persistent left hypoglossal artery arising from the left internal carotid artery at the level of the C-1 vertebra. Retrograde vertebral angiograms revealed right hypoplastic vertebral artery (2mm in diameter) and markedly hypoplastic left vertebral artery, vanishing at the level of the C-3 vertebra. The axial view of the left carotid angiogram demonstrated the hypoglossal artery entered into the cranial cavity through the hypoglossal canal. Linear tomogram in the modified reversed Stenvers projection demonstrated the enlarged left hypoglossal canal measuring 9 X 10 mm. The normal right canal measured 5 X 6 mm. The right frontotemporal craniotomy was performed and the aneurysm was successfully clipped at its neck under an operative microscope. The patient discharged without any neurological deficit. The persistent hypoglossal artery is one of the persistent carotidbasilar anastomoses. Ninety-six cases of the hypoglossal arteries have been reported in literature. Twenty cases of them were associated with intracranial aneurysms. The authors reviewed these twenty cases and discussed the genesis of the intracranial congenital aneurysm in relation to the persistent artery.