Fact-sheet: Persistent hypoglossal artery


Updated on 08/26/2020 at 1:59 PM

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Definition

Persistent anastomosis between the vertebrobasilar system and the internal carotid system.
This anomaly results from interrupted embryogenesis.

It arises from the posterior aspect of the internal carotid artery, at the C1 or C2 level.
Its caliber is generally similar to that of the ICA.
It then enters the posterior fossa through the hypoglossal canal, terminating in the basilar trunk.

Clinical features

  • Asymptomatic
  • Glossopharyngeal neuralgia
  • Headaches (SAH if aneurysm rupture)

CT

  • Bone window: Enlargement of the hypoglossal canal
  • CT angiography of the supra-aortic trunks: Agenesis or hypoplasia of the vertebral arteries
  • Incomplete circle of Willis
  • Fusion defect of the basilar artery.