Presentation
Headache and giddiness since many years.
Patient Data
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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.
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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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