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Persistent hypoglossal artery

Case contributed by Vinay V Belaval
Diagnosis certain

Presentation

Headache and giddiness since many years.

Patient Data

Age: 60 years
Gender: Female

MRI Brain and MR angiography

mri

There is bilateral native vertebral artery hypoplasia. A large caliber ascending arterial channel was seen arising from the distal cervical segment of the left internal carotid artery, passing through the left hypoglossal canal and reforming the basilar artery - consistent with persistent hypoglossal artery.   

Chronic small vessel ischemic changes are seen in bilateral corona radiata, left thalamus and left centrum semiovale. Chronic lacunar infarcts are seen in head of right caudate nucleus.

Posterior fossa appears normal.

Annotated images

mri

Persistent hypoglossal artery is seen arising from the distal cervical segment of the left internal carotid artery, passing through the left hypoglossal canal and reforming the basilar artery.

Case Discussion

Hypoplastic native vertebral arteries with reformation of basilar artery by an ascending persistent arterial channel between the left ICA and basilar artery - consistent with persistent hypoglossal artery

Other primitive persistent communications between carotid and basilar systems include persistent acoustic artery and persistent trigeminal artery.

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