Journal Article

Persistent primitive hypoglossal artery: a case study with a dissertation on its embryopathological rationale

Serraino, Alessandra, Pace, Marco, Galassi, Francesco Maria, te, Flavio, Artico, Marco, Palmieri, Mauro, Danti, Massimiliano

2024

Overview

First described during an anatomical dissection in 1889 (Batujeff1889), with its first angiographic description dating back to 1961 (Begg 1961), PPHA may occur in association with aneurysms (Nakamura et al. 2000) and its well-known association with the ipsilateral vertebral artery agenesia (VA) seems to play an ischemic role in the event of inflow reduction in ICA, which alone supplies vascularisation on its own side (Zhang et al. 2016). CASE REPORT A 55-year-old female patient referred to our Cardiology Outpatient Service with a high cardiovascular risk (i.e. smoking, high cholesterol levels) without specific symptoms: since atherosclerosis, as is currently known, is multi-district disease, there is a tendency shared between radiologists and cardiologists to perform a single exam to study both the coronaries and epiaortic vessels, thus benefiting from a single administration of contrast medium. The multi-slice CardioSync CT Scan (Siemens Somatom Volume Zoom) for the study of coronary arteries and epiaortic vessels after riodine non-ionic contrast medium administration was used: the volume rendering reconstruction (Fig. 1) of the epiaortic vessels shows an anomalous bifurcation of the ICA, which gives rise to the ICA itself, which ascends without collateral branches up to the carotid foramen in the cranial base, and to an accessory artery, which enters the hypoglossal canal on the contour of the great occipital foramen, as a PPHA. The arteries of the sixth branchial arch contribute to the formation of the two primitive pulmonary arteries with their proximate portion, while there is no scientific agreement on the role of the artery of the fifth branchial arch (Klostranee & Krings 2022). b. Vascular anomalies The most common vascular anomalies of the vessels of the neck (Fig. 5) include the common origin of the brachiocephalic trunk and leftCommon Carotid Artery (CCA), the aberrant right subclavian artery, also called arteria lusoria, the ICA aplasia or hypoplasia; ICA is embryologically divided into 7 segments (I - cervical, II - ascending petrosus, III - horizontal petrosus, IV - ascending cavernous, V - horizontal cavernous, VI - clinoid and VII - terminal): ICA hypoplasia is frequently seen close to the bifurcation (segment I) (Kathuria et al. 2011), while the aplasia is observed at carotid foramen (segment II, with canal of reduced caliber or even absent) (Given et al. 2001).

• Publisher: Firenze University Press Università degli Studi di Firenze
• Subject: Aplasia / Arteriosclerosis / Canals (anatomy) / Cardiovascular diseases / Carotid arteries / Carotid artery / Cholesterol / Computed tomography / Contrast media / Coronary artery / Coronary vessels / Females / Hypoplasia / Ischemia / Morphology / Pulmonary arteries / Pulmonary artery / Veins & arteries / Vertebrae