Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 4, Issue 6 | Case Report | Open Access
Sonia Lucchese*
Sonia Lucchese1*, Gioacchino Massimo Novello2, Antonello Vidiri1 1Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Italy 2Radiology and Diagnostic Imaging Department, Azienda Ospedaliera San Giovanni Addolorata, Italy
*Correspondence to: Sonia Lucchese
Fulltext PDFBackground: Persistent primitive hypoglossal artery (PPHA) is a rare carotid–basilar anastomosis that may persist into adulthood and become clinically relevant when associated with vascular pathology or cranial neuropathy.
Methods: A middle-aged woman (51 years) presented with right hemilingual edema, dysphagia, and sialorrhea. Imaging demonstrated a persistent hypoglossal artery complicated by arterial dissection within the hypoglossal canal, along with secondary signs of hypoglossal nerve palsy. The patient was managed conservatively with antihypertensive therapy.
Results: The imaging findings correlated with the patient’s clinical symptoms, revealing that the PPHA was the site of both vascular injury and cranial neuropathy.
Conclusions: This case underscores that PPHA, although often incidental, can give rise to significant complications such as arterial dissection and hypoglossal nerve palsy. Recognition of this vascular variant is essential to avoid misdiagnosis and to guide safe management of cervico-cranial vascular disease.
Persistent hypoglossal artery; Arterial dissection; Hypoglossal nerve palsy; Vascular anomaly; Case report
Sonia Lucchese, Gioacchino Massimo Novello, Antonello Vidiri. Persistent Hypoglossal Artery Dissection: A Rare Cause of Hypoglossal Nerve Palsy. Annal of Otol Head and Neck Surg. 2025;4(6):1-4.