Sunada I, Yamamoto S, Matsuoka Y, Nishimura S
Department of Neurosurgery, Yamamoto Daisan Hospital, Osaka.
Neurol Med Chir (Tokyo). 1991 Feb;31(2):104-8. doi: 10.2176/nmc.31.104.
Persistent primitive hypoglossal artery, an anastomosis between the carotid artery and the vertebrobasilar system, is found in about 0.05% of cerebral angiograms. Though usually asymptomatic, it may occasionally cause ischemic disease. A 62-year-old male presented with left hemiparesis. Right carotid angiograms demonstrated a primitive hypoglossal artery originating from the internal carotid artery at the 2nd cervical spine. This artery supplied almost all blood to the basilar artery system. A marked stenosis extended from the origin of the internal carotid artery to the primitive hypoglossal artery. An endarterectomy of the internal carotid and primitive hypoglossal arteries was performed using a special internal shunt 46 days after the onset. Sudden arterial bleeding from the incised part of the internal carotid artery occurred 12 days after the operation. The carotid artery was resutured. The rupture of the carotid artery appeared to be caused by an infection of Pseudomonas aeruginosa, which was detected by culture of the chronic ear discharge. Rupture of the vessel wall due to infection is an important complication after endarterectomy. This is the second reported endarterectomy of the primitive hypoglossal artery.
永存原始舌下动脉是颈动脉与椎基底动脉系统之间的一种吻合，在约0.05%的脑血管造影中被发现。虽然通常无症状，但偶尔可能导致缺血性疾病。一名62岁男性出现左侧偏瘫。右侧颈动脉造影显示一条原始舌下动脉起源于第二颈椎水平的颈内动脉。这条动脉几乎为基底动脉系统供应了所有血液。从颈内动脉起始处到原始舌下动脉有明显狭窄。发病46天后，使用特殊的体内分流器对颈内动脉和原始舌下动脉进行了内膜切除术。术后12天，颈内动脉切开部位突然发生动脉出血。对颈动脉进行了再次缝合。颈动脉破裂似乎是由铜绿假单胞菌感染引起的，通过对慢性耳漏进行培养检测到了该病菌。感染导致的血管壁破裂是内膜切除术后的一个重要并发症。这是第二例报道的原始舌下动脉内膜切除术。
