Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 15, 2008
Persistent Hypoglossal Artery
- The persistent hypoglossal artery (PHA) is the second most common persistent carotid-basilar anastomosis after the trigeminal artery.
- PHA originates from the posterior side of the cervical part of the internal carotid artery at the level of C1-C2 and enters the skull through an enlarged hypoglossal canal; it ends in the basilar artery.
- When present, PHA is often the exclusive feeder of the posterior circulation and is associated with hypoplasia of the vertebral arteries.
- This vascular variant can be associated with hypoglossal nerve palsy, basilar artery aneurysm, and cranio-cervical junction bone malformations.
- Temporary clamping of the hypoglossal artery during CEA carries greater ischemic risk.
- Differential diagnosis: type I proatlantal artery enters the skull through the foramen magnum.
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