Abstract
Persistent hypoglossal artery (PHA) is a relatively rare vascular anomaly of persistent carotid-basilar anastomosis and is usually asymptomatic. In this report, we describe a 73-year-old male patient who was admitted to our hospital due to sudden consciousness disturbance, right oculomotor palsy, left MLF syndrome, bilateral cortical blindness, and severe left hemiparesis. MRI/A at admission revealed acute cerebral infarction in both the carotid and vertebral artery territories, and moderate internal carotid artery stenosis associated with ipsilateral PHA. Artery-to-artery embolism from the internal carotid artery is thought to be the cause of this multiterritorial infarction. It should be borne in mind that persistent carotid-basilar anastomosis can cause multi-territorial cerebral infarction mimicking cardioembolism, and may be a candidate for aggressive prophylactic intervention when complicated by occlusive carotid artery diseases.
