This report describes imaging in a patient with a unique unnamed carotid-basilar anastomosis, where the entry into the skull was via the jugular foramen. There were associated findings of absent right and hypoplastic left vertebral arteries and an aberrant right subclavian artery. We speculate that the persistent anastomosis is developmentally related to the jugular branch of the ascending pharyngeal artery. Clinical implications of the course via the jugular foramen are also discussed.
DimmickSJFaulderKC. Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics. 2009; 29: 1027–1043.
2.
LuhGYDeanBLTomsickTA. The persistent fetal carotid-vertebrobasilar anastomoses. Am J Roentgenol. 1999; 172: 1427–1432.
3.
VasovicLArsicSVlajkovicS. Otic artery: A review of normal and pathological features. Med Sci Monit.2010; 16: RA101–109.
4.
LeeEJChangHWChoCH. Rare variant of persistent primitive hypoglossal artery in magnetic resonance angiography. Surg Radiol Anat (serial on the internet)2010 Apr 14; (about 4 screens). Available from: http://www.springerlink.com/content/k5025213m-5p44l0p/.
Hacein-BeyLDanielsDLUlmerJL. The ascending pharyngeal artery: Branches, anastomoses, and clinical significance. Am J Neuroradiol. 2002; 23: 1246–1256.
7.
GuttenburgRA. Fetal carotid-vertebrobasilar anatomoses: Persistent hypoglossal artery associated with further variations of the circle of Willis. Surg Radiol Anat.2009; 31: 311–315.
8.
AvcuSVan der SchaafIOzcanH. Persistent hypoglossal artery detected incidentally in a hypertensive patient with intracerebral haemorrhage: A case report and review of the literature. Cases J.2009; 2: 8571.
