Tsugu A, Matsumae M, Ikeda A, Sato O
Department of Neurosurgery, Tokai University School of Medicine.
No Shinkei Geka. 1990 Jan;18(1):95-100.
The authors describe a case of persistent primitive hypoglossal artery aneurysm in a 42-year-old woman who had complained of headache, mainly in the occiput, for 5 days prior to admission. Because of a sudden exacerbation of the headache associated with vomiting, she was hospitalized on July 31, 1988. On admission, a cranial computed tomography scan demonstrated a high density lesion in the basal cisterns which suggested subarachnoid hemorrhage (SAH). Right carotid angiography revealed a persistent primitive hypoglossal artery and an aneurysm arising from this artery at the junction of the posterior inferior cerebellar artery. Bilateral vertebral arteries were shown to be hypoplastic. This was followed by a right suboccipital craniectomy on the 6th hospital day at which time a neck clipping was made. Her postoperative course was uneventful. On discharge on August 22, she was ambulatory and had no neurological deficit except for a mild hoarseness which developed after surgery. Well over one hundred cases of persistent primitive hypoglossal artery aneurysm have been reported. However, as far as we could discern, there have been only 9 cases of persistent primitive hypoglossal artery aneurysm including this present case. Most of the cases had SAH due to the rupture of these aneurysms with favorable outcome after the surgery. In addition, some embryological considerations were made.
作者描述了一例42岁女性持续性舌下动脉原始动脉瘤病例，该患者在入院前5天一直主诉头痛，主要位于枕部。由于头痛突然加剧并伴有呕吐，她于1988年7月31日住院。入院时，头颅计算机断层扫描显示脑基底池有高密度病变，提示蛛网膜下腔出血（SAH）。右侧颈动脉血管造影显示存在持续性舌下动脉原始血管以及在小脑后下动脉交界处由该动脉发出的一个动脉瘤。双侧椎动脉发育不良。在住院第6天进行了右侧枕下颅骨切除术，同时进行了颈部动脉瘤夹闭术。她的术后过程顺利。8月22日出院时，她可自由活动，除了术后出现轻度声音嘶哑外无神经功能缺损。已报道了一百多例持续性舌下动脉原始动脉瘤病例。然而，据我们所知，包括本病例在内仅有9例持续性舌下动脉原始动脉瘤病例。大多数病例因这些动脉瘤破裂导致SAH，术后预后良好。此外，还进行了一些胚胎学方面的思考。
