Abstract
Two cases of the persistent primitive hypoglossal artery associated with aneurysm have been reported.
Case 1. A 48 year-old woman ad mitt ed to our clinic with subarachnoid hemorrhage. Left carotid angiography revealed an aneurysm of the anterior communicating artery and the persistent primitive hypoglossal artery. Under the hypothermic anesthesia, the aneurysmal neck was ligated. About 1 month the operation, she left our clinic in good condition.
Case 2. A 34 year-old woman was admitted with subarachnoid hemorrhage. The right an giogram showed the persistent primitive hypoglossal artery with an aneurysm at its entertion into cranium. Under the hypothermia, the aneurysmal neck was directly ligated carefully avoiding the cerebral blood flow interruption of that artery. About 1 month after the operation, she was discharged in good condition.
We collected 59 reported cases of the persistent primitive hypoglossal artery including our two cases. Reviewing these cases, the symptoms and signs are related with other coexisting anomalous condition rather than persisting primitive hypoglossal artery itself. It is commonly found at a chance of medical examination suspecting intracranial lesions, such as aneurysms or brain tumors and so on. On the literature 6 cases of the intracranial aneurysm are reviewed in the 59 cases of this primitive artery with incidence of 10%.
Vertebral arteries are often hypoplastic or not visualized on angiograms. Thus it must be emphasized that preservation of the primitive hypoglossal arterial flow as a collateral circulation is necessary on the direct surgery for the accompaning aneurysm.
