title: Ruptured aneurysm arising from a basilar artery fenestration and associated with a persistent primitive hypoglossal artery. Case report and review of the literature.
abstract: A 42-year-old woman experienced the sudden onset of a severe headache. Angiograms demonstrated a persistent primitive hypoglossal artery (PHA) originating from the internal carotid artery at the C-2 vertebral level. In addition, a fenestration at the PHA-basilar artery (BA) junction and an aneurysm at the proximal end of this fenestration were revealed. To perform endovascular embolization of the aneurysm, a microcatheter was introduced into the aneurysm sac via the PHA and two Guglielmi Detachable Coils were placed in the aneurysm. The patient's postoperative course was uneventful, and she was able to resume her normal life. Although many clinical cases have been reported in which a ruptured aneurysm was associated with a PHA or a BA fenestration, as far as the authors know there has been no case in the literature in which a ruptured aneurysm associated with both anomalies and no case in which endovascular embolization was used to treat a ruptured aneurysm associated with a PHA. This rare case is discussed and a review of the relevant literature is presented.
authors.affiliation: Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kanematsu
authors.forename: Koichi
authors.initials: K
authors.lastname: Satoh
authors.forename: Norio
authors.initials: N
authors.lastname: Nakajima
authors.forename: Fusamitsu
authors.initials: F
authors.lastname: Hamazaki
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagahiro
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000002:abnormalities / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed