Endovascular treatment of AVM-associated aneurysm of anterior inferior cerebellar artery through persistent primitive hypoglossal artery

Abstract

We present a patient with the combination of persistent primitive hypoglossal artery and the origin of left common carotid artery from the brachiocephalic trunk, who had subarachnoid haemorrhage caused by a ruptured aneurysm. The aneurysm was on distal anterior inferior cerebellar artery which was a feeder to cerebellar arterio-venous malformation.

Anatomy of the feeding arteries of the cerebral arteriovenous malformations

“…They commonly originated from the MCA, and less frequently from the ACA, PCA, BA or VA (Tables 1, 2). In general, our results are in accordance with other reports [16,24,34,50,56,61,78]. Nevertheless, it is obvious that the AVMs location and the position of the parent arteries mainly determine the type of the feeders.…”

“…The presence of an aneurysm on a feeding artery is very important clinically because it may rupture, either spontaneously, or during or after an endovascular radiologic procedure. In both cases, a dangerous subarachnoid haemorrhage occurs or an intraparenchymal haematoma develops [10,50,54,78]. As regards the intranidal and postnidal venous pouches and aneurysms, they are out of the scope of this study.…”

“…Obviously, the AVMs can be located in any part of the brain, which means that any cerebral artery can become a feeder [1,5,14,16,18,24,27,33,34,45,46,50,51,61,65,74,78]. The type of the feeding vessels depends firstly on a deep or superficial AVMs position.…”

“…The feeders originating from some other persistent embryonal vessels were seen extremely rarely, e.g. from the primitive olfactory or hypoglossal artery [28,50]. Finally, some AVMs feeders are associated with the arterial fenestration [71], and some others with the moyamoya vessels [3,49].…”

“…Firstly, the involvement of certain feeders and location of their AVMs can usually explain neurologic signs and symptoms in patients. Secondly, feeders are used during the endovascular interventional radiologic procedure [16,[50][51][52][53]80]. Thirdly, some feeders are the site of neurosurgical intervention [14,18,24,27,45,69,78].…”