De Caro R, Parenti A, Munari P F
Institute of Human Anatomy, University of Padua, Italy.
Ann Anat. 1995 Mar;177(2):193-8. doi: 10.1016/S0940-9602(11)80073-7.
The case of a persistent primitive hypoglossal artery (PHA) in a 72-year-old man dead from myocardial infarction is presented. The autopsy showed the presence of a semicircular marginal infarct on the surface of the left cerebral hemisphere. The PHA anastomized the basilar artery origin with the left internal carotid artery, running through the left hypoglossal canal together with the hypoglossal nerve. The vertebral and posterior communicating arteries were hypoplastic. The PHA represented the morphological base on which the cerebral vascular insufficiency acted, following the generalized circulatory insufficiency due to the myocardial infarct, causing the cerebral infarct. Based on the embryology of the cranial arteries and on the morphological findings we suggest that the persistence of the hypoglossal artery: 1) precedes the vertebral and posterior communicating arteries hypoplasia causing it by competition for the territory of distribution; 2) gives rise to an almost complete dependence of the cerebral circulation from the carotid system with predictable ischemic consequences in the case of a critical reduction of the carotid blood flow; 3) may be associated with an anomalous structure of the vessel wall and exposes the basilar trunk to an unusual haemodynamic stress, predisposing to the onset of aneurysms.
本文报告了一例72岁因心肌梗死死亡男性患者的持续性原始舌下动脉（PHA）病例。尸检显示左大脑半球表面存在半圆形边缘梗死灶。PHA将基底动脉起始部与左颈内动脉吻合，与舌下神经一起穿过左舌下神经管。椎动脉和后交通动脉发育不全。PHA是脑血管供血不足的形态学基础，继心肌梗死导致的全身循环功能不全之后，引起脑梗死。基于颅动脉的胚胎学和形态学发现，我们认为舌下动脉持续存在：1）先于椎动脉和后交通动脉发育不全，因对分布区域的竞争导致其发育不全；2）导致脑循环几乎完全依赖颈动脉系统，在颈动脉血流严重减少时会产生可预测的缺血后果；3）可能与血管壁结构异常有关，并使基底干承受异常的血流动力学压力，易引发动脉瘤。
