Pediatric Radiology

, Volume 40, Supplement 1, pp 162–162

Persistent hypoglossal artery

Clinical Image
A 7-year-old girl underwent brain MRI and MRA for headaches. The MRA demonstrated an anomalous artery coursing through the right hypoglossal canal (Fig. 1, arrow) to form the basilar artery with a hypoplastic left vertebral artery (arrowhead). No right vertebral artery was seen. T1-W images obtained below the MRA slab showed the flow void of this anomalous vessel originating from the right cervical internal carotid artery (Fig. 2, asterisk), confirming a persistent hypoglossal artery.
Fig. 1

Axial source image from 3D-TOF MRA

Fig. 2

Axial T1-W MRI

Of the four primitive carotid-basilar anastomoses that normally regress in utero, the hypoglossal artery is the second most likely (after the trigeminal artery) to persist postnatally (0.03–0.26% of patients) [1]. The vertebral and posterior communicating arteries are frequently absent or hypoplastic with the carotid of origin therefore mainly supplying the brainstem [2]. While typically incidental in the pediatric population, consideration should be given to this artery in skull base surgery, Wada testing and carotid injuries or interventions [1].


  1. 1.
    Wagner AL (2001) Isolated stenosis of a persistent hypoglossal artery visualized at 3D CT angiography. AJNR 22:1613–1614PubMedGoogle Scholar
  2. 2.
    Hahnel S, Hartmann M, Jansen O et al (2001) Persistent hypoglossal artery: MRI, MRA, and digital subtraction angiography. Neuroradiology 43:767–769PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of RadiologyChildren’s Hospital of AlabamaBirminghamUSA

Personalised recommendations