Hopf-Jensen S, Marques L, Preiß M, Börm W, Müller-Hülsbeck S
Department of Diagnostic and Interventional Radiology and Neuroradiology, Diakonissenhospital Flensburg, Flensburg, Germany.
Department of Neurosurgery, Diakonissenhospital, Flensburg, Germany.
Int J Angiol. 2017 Jun;26(2):121-124. doi: 10.1055/s-0035-1568879. Epub 2015 Dec 8.
We present a very rare variation of a persistent primitive hypoglossal artery (PPHA) arising from the internal carotid artery, detected during a diagnostic angiography. A 50-year-old female patient was admitted with an atypical intracranial hematoma in the left frontal lobe. Catheter angiography revealed intracranial vasculopathy with segmental stenoses, a small aneurysm of the right internal carotid artery bifurcation and a "string of beads" appearance of the left carotid artery, consistent with fibromuscular disease. On the left side, a vertebral artery ending in the posterior inferior cerebellar artery (PICA) was detected, whereas on the right side the vertebral artery was aplastic. During selective angiography of the right common carotid artery, a persistent hypoglossal artery was seen supplying the basilar artery. The literature of persistent embryonal carotid-vertebrobasilar anastomosis and their anatomical variations is discussed with respect to clinical importance for ischemia, interventional procedures, and surgery.
我们报告了一例极为罕见的持续性原始舌下动脉（PPHA）变异，其起源于颈内动脉，在诊断性血管造影过程中被发现。一名50岁女性患者因左侧额叶非典型颅内血肿入院。导管血管造影显示颅内血管病变伴节段性狭窄、右颈内动脉分叉处小动脉瘤以及左颈动脉呈“串珠样”表现，符合纤维肌性疾病。在左侧，检测到一条椎动脉终止于小脑后下动脉（PICA），而右侧椎动脉发育不全。在右颈总动脉选择性血管造影期间，可见一条持续性舌下动脉供应基底动脉。本文就持续性胚胎期颈动脉 - 椎基底动脉吻合及其解剖变异的文献，探讨了其在缺血、介入操作和手术方面的临床重要性。
