Basilar stroke from a persistent hypoglossal artery.
Occlusion of the basilar artery can be treated with endovascular thrombectomy, although the results have not been well studied. Persistent fetal cerebrovascular anatomy can lead to unusual presentation of carotid atherosclerotic disease and can be a barrier to successful mechanical thrombectomy if not recognized. This case presents a rare persistent carotico-basilar anastomosis which resulted in basilar occlusion via the persistent hypoglossal artery and coincident absence of contralateral vertebral arterial access due to a left vertebral artery terminating in the left posterior inferior cerebellar artery. Preoperative recognition of this anatomy afforded by review of cross-sectional imaging was critical to success during this emergent procedure.
Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Alfred P
http://orcid.org/0000-0003-3634-4692
AP
See
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Jacob F
JF
Baranoski
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Bruno C
BC
Flores
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Andrew
A
Ducruet
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Felipe C
FC
Albuquerque
D000368:Aged; D001488:Basilar Artery / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002548:Cerebral Revascularization / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D017131:Thrombectomy / Q000379:methods; D014711:Vertebral Artery / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery
Embolic; Stroke; Thrombolysis