title: Manual aspiration thrombectomy for basilar infarction in the setting of a persistent primitive hypoglossal artery: Case report and review of the literature.
abstract: BACKGROUND
  Persistent primitive hypoglossal artery (PPHA), a remnant of embryonal circulation, is a rare variant of the posterior cerebral circulation. Seven prior cases of posterior circulation stroke in the setting of PPHA have been described in the literature, with all but one case being attributable to atherosclerotic embolization from the internal carotid artery (ICA) through the PPHA.
  
  
  METHODS
  We report a unique case of a young male with a PPHA presenting with a "top of the basilar" syndrome following the repair of his atrial septal defect who underwent emergent revascularization via endovascular mechanical aspiration thrombectomy. The patient underwent a successful aspiration thrombectomy with significant improvement in his clinical exam.
  
  
  CONCLUSIONS
  Considering the rarity of this persistent fetal anastamosis, it is important to be aware of the propensity for unusual presentations in the context of stroke, understand the management of the problem, and expeditiously treat the patient.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center 200 Lothrop Street, Suite c-400 15207 Pittsburgh, PA, USA.
authors.forename: Zoya
authors.initials: Z
authors.lastname: Voronovich
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center 200 Lothrop Street, Suite c-400 15207 Pittsburgh, PA, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Grandhi
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center 200 Lothrop Street, Suite c-400 15207 Pittsburgh, PA, USA.
authors.forename: Nathan T
authors.initials: NT
authors.lastname: Zwagerman
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center 200 Lothrop Street, Suite c-400 15207 Pittsburgh, PA, USA.
authors.forename: Ashutosh P
authors.initials: AP
authors.lastname: Jadhav
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center 200 Lothrop Street, Suite c-400 15207 Pittsburgh, PA, USA.
authors.forename: Tudor G
authors.initials: TG
authors.lastname: Jovin
keywords: Basilar Infarction; persistent primitive hypoglossal artery; thrombectomy