The Teaching Point

Fetal anastomotic variants can create misleading clinical findings in the patients presenting with stroke syndromes. Arterial emboli originating from a fetal anastomotic vessel can result in stroke that can mimic a cardio-embolic source due to ischemia in multiple vascular territories typically supplied by separate vessels. Timely identification of pathology including atherosclerotic plaque associated with these vascular variants on non-invasive imaging like computerized tomography angiogram is critical to identify the source of stroke and in guidance of potential therapy including surgical or endovascular intervention.






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From the manuscript

Bilateral persistent primitive hypoglossal arteries associated with unilateral symptomatic carotid thromboembolism

Free full text article: Bilateral persistent primitive hypoglossal arteries associated with unilateral symptomatic carotid thromboembolism

Abstract
We report the fifth case of bilateral persistent primitive hypoglossal arteries in the literature. This is also the first such case to be demonstrated on computerized tomography angiogram (CTA) and the first case to be associated with a symptomatic carotid thrombus. The sub-occlusive thrombus was distal to the take-off of the dominant persistent hypoglossal artery (PHA) from the internal carotid artery, thus sparing involvement of posterior circulation. Timely identification of the internal carotid artery thromboembolism in the setting of a PHA is important to allow for thrombectomy. Any intervention was not done in this case as the patient was out of the window and at an additional risk of inducing intracranial thromboembolism. Symptomatic carotid stenosis at the PHA take-off is typically treated with endovascular angioplasty and stenting due to the typically high level of the bifurcation in the neck.






References



1. Uchino A, Saito N, Okada Y, Kozawa E, Nishi N, Mizukoshi W, Inoue K, Nakajima R, Takahashi M. Persistent hypoglossal artery and its variants diagnosed by CT and MR angiography. Neuroradiology 2013 Jan 1;55(1):17-23
Get full text
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2. Karasawa J, Kikuchi HA, Furuse SE, Sakaki TO, Yoshida YA, Ohnishi HI. Bilateral persistent carotid-basilar anastomoses. American Journal of Roentgenology 1976 Dec 1;127(6):1053-6
Get full text
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3. Murayama Y, Fujimoto N, Matsumoto K. Bilateral persistent primitive hypoglossal arteries associated with a large ruptured aneurysm on one side. Surgical neurology 1985 Nov 30;24(5):498-502
Get full text
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4. Garge S, Moses V, Keshava S, Ahmed M, Moorthy R. Persistent hypoglossal arteries with aneurysmal dilation of left hypoglossal artery: a rare case report and review of the literature. BJR case reports 2016 May:20150301.
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Takahashi H, Tanaka H, Fujita N, Tomiyama N. Bilateral persistent hypoglossal arteries: MRI findings. The British journal of radiology 2014 Jan 28
Get full text
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6. Kawano H, Inatomi Y, Hirano T, Yonehara T. Cerebral infarction in both carotid and vertebrobasilar territories associated with a persistent primitive hypoglossal artery with severe dilated cardiomyopathy. Journal of Stroke and Cerebrovascular Diseases 2014 Jan 31;23(1):176-8
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


7. Zhang L, Song G, Chen L, Jiao L, Chen Y, Wang Y. Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection. Journal of vascular surgery 2016 Jan 31;63(1):237-40
Get full text
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8. Silva CF, Hou SY, Kühn AL, Whitten RH, Wakhloo AK. Double embolic protection during carotid artery stenting with persistent hypoglossal artery. Journal of neurointerventional surgery 2014 Apr 1;6(3):e23-
Get full text
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9. Murai S, Kusaka N, Umakoshi M, Itami H, Otsuka S, Nishiura T, Ogihara K. Stenting for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery Using Proximal Flow Blockade and Distal Protection System: A Technical Case Report and Literature Review. Journal of Stroke and Cerebrovascular Diseases 2016 Jun 30;25(6):e98-102
Get full text
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10. Ryu B, Ishikawa T, Hashimoto K, Shimizu M, Yagi S, Shimizu T, Kawamata T. Internal carotid artery stenosis with persistent primitive hypoglossal artery treated with carotid artery stenting: A case report and literature review. The neuroradiology journal 2016 Apr 1;29(2):115-21
Get full text
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11. Koleilat I, Hanover T. Carotid Endarterectomy in the Face of a Persistent Hypoglossal Artery. Annals of vascular surgery 2015 Nov 30;29(8):1660-e1
Get full text
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