Persistent Primitive Hypoglossal Artery Associated With Multiple Cerebral Aneurysms

Persistent primitive hypoglossal artery is a rare anastomosis between the carotid and basilar arteries, and sometimes associated with cerebral aneurysms. However, association of persistent primitive hypoglossal artery with aneurysms located on arteries other than persistent primitive hypoglossal artery itself or posterior circulation is very rare. An 80-year-old woman suffered from subarachnoid hemorrhage, whose angiography demonstrated aneurysms on the left middle cerebral artery and anterior communicating artery, and the left persistent primitive hypoglossal artery. The middle cerebral artery aneurysm was the origin of hemorrhage. Although repeated craniotomy was necessary for the left middle cerebral artery aneurysm, both aneurysms were successfully clipped. In our case, neither aneurysm was located on an artery related to the persistent primitive hypoglossal artery. There is a possibility that cases of persistent primitive hypoglossal artery are accompanied by cerebral aneurysms on arteries other than the persistent primitive hypoglossal artery or in the posterior circulation.