We describe a 22-year-old woman admitted to hospital in emergency with nuchal headache and vomiting. CT scan disclosed subarachnoid hemorrhage. Digital subtraction angiography with three-dimensional rotational acquisitions showed a ruptured aneurysm of a right persistent primitive hypoglossal artery as the cause of symptoms and hemorrhage. The patient was successfully treated with endovascular coiling of the aneurysm. This is the second literature report describing endovascular treatment in this unusual condition.
CaldemeyerKSCarricoJBMathewsVP: The radiology and embryology of anomalous arteries of the head and neck. Am J Radiol170: 197–203, 1998.
2.
UchinoASawadaA: MR angiography of the anomalous branches of the internal carotid artery. Am J Radiol181: 1409–1414, 2003.
3.
PadgetDH: Designation of the embryonic intersegmental arteries in reference to the vertebral artery and subclavian stem. Anat Rec119: 349–356, 1954.
4.
HolminSOzanneA: Association of cervical internal carotid artery aneurysm with ipsilateral vertebrobasilar aneurysm in two children: A segmental entity?Childs Nerv Syst23: 791–798, 2007.
YilmazEIlgitETanerD: Primitive persistent carotid-basilar and carotid-vertebral anastomoses: A report of seven cases and a review of the literature. Clin Anat8: 36–43, 1995.
7.
De CaroRParentiAMunariPF: The persistent primitive hypoglossal artery: A rare anatomic variation with frequent clinical implications. Ann Anat177: 193–198, 1995.
8.
PascoAPaponX: Persistent carotid-vertebrobasilar anastomoses. How and why differentiating them?J Neuroradiol31: 391–396, 2004.
9.
KanematsuMSatoK: Ruptured aneurysm arising from a basilar artery fenestration and associated with a persistent primitive hypoglossal artery. Case report and review of the literature. J Neurosurg101: 532–535, 2004.
HatayamaTYamaneK: Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis — Case report. Neurol Med Chir (Tokio)39: 372–375, 1999.
12.
MazighiMPorterPJ: Vascular anomalies and the risk of multiple aneurysms development and bleeding. Interventional Neuroradiology8: 15–20, 2002.
13.
YamamotoSSunadaI: Persistent primitive hypoglossal artery aneurysms — Report of two cases. Neurol Med Chir (Tokio)31: 199–202, 1991.
14.
Al-MemarATrushD: Unilateral hypoglossal nerve palsy due to aneurysm of the stump of persistent hypoglossal artery. J Neurol Neurosurg Psychiatry64: 405, 1998.
15.
DuffillJLangDADwyerGN: Subarachnoid haemorrhage in a child from an aneurysm of a persistent primitive hypoglossal artery. Br J Neurosurg10: 607–610, 1996.
16.
KanaiHNagaiH: A large aneurysm of the persistent primitive hypoglossal artery. Neurosurgery30: 794–797, 1992.
17.
MurayamaYFujimotoNMatsumotoK: Bilateral persistent primitive hypoglossal arteries associated with a large ruptured aneurysm on one side. Surg Neurol24: 498–502, 1985.
18.
KringsTLasjauniasPL: The aneurysmal wall. The key to a subclassification of intracranial arterial aneurysm vasculopathies?Interventional Neuroradiology14: 39–47, 2008.
19.
BaltsaviasGMChourmouziD: Ruptured aneurysm of a persistent primitive hypoglossal artery treated by endovascular approach — Case report and literature review. Surg Neurol68: 338–343, 2007.
20.
BaldiSZanderT: Stent-assisted coil embolization of a wide-neck aneurysm of a persistent primitive hypoglossal artery. Cardiovasc Intervent Radiol DOI 10.1007/s00270-008-9415-4.
