title: Cerebral infarction in both carotid and vertebrobasilar territories associated with a persistent primitive hypoglossal artery with severe dilated cardiomyopathy.
abstract: A persistent primitive hypoglossal artery (PPHA) is a relatively rare vascular anomaly of a persistent carotid-basilar anastomosis. A 76-year-old man with severe dilated cardiomyopathy suddenly lost consciousness. A magnetic resonance imaging scan of his brain revealed extensive infarction in the carotid and vertebrobasilar territories. Magnetic resonance angiography revealed a PPHA and occlusion of the left internal carotid artery and vertebrobasilar artery. Cardioembolic infarction associated with a PPHA should be recognized as a possible cause of multiple infarctions in both the carotid and vertebrobasilar distributions in the absence of stenotic ICA lesions.
authors.affiliation: Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: hkawanoo@gmail.com.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Inatomi
authors.affiliation: Department of Neurology and Neuromuscular Disorders, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yonehara
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002339:Carotid Arteries / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology*; D002536:Cerebral Arteries / Q000002:abnormalities* / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D004617:Embolism / Q000150:complications; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D014463:Ultrasonography; D014474:Unconsciousness / Q000150:complications; D014715:Vertebrobasilar Insufficiency / Q000473:pathology*