{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:02:21Z","timestamp":1778173341487,"version":"3.51.4"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,23]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>We report a case of symptomatic, progressive stenosis of a persistent primitive hypoglossal artery (PPHA), which was successfully treated with percutaneous transluminal angioplasty (PTA) of the origin of the PPHA. The PPHA is a type of carotid-basilar anastomosis with an incidence of 0.02% to 0.10%. It originates from the internal carotid artery (ICA), passes through the hypoglossal canal, and merges with the basilar artery. In many cases, the ipsilateral vertebral artery is hypoplastic; therefore, PPHA stenosis causes cerebral infarction in the posterior circulation territory, as in this case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The patient\u2019s right PPHA had severe and progressive stenosis; therefore, he experienced cerebral infarction despite medical treatment. Therefore, PTA for the stenosis was performed, which ceased the recurrence of cerebral infarction and dizziness by improving blood flow in the posterior circulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Several reports have described ICA stenosis accompanied by PPHA or PPHA stenosis in patients receiving endovascular treatments. Almost all cases were nonprogressive, and the treatment procedure was stenting. However, in our case, the PPHA stenosis was progressive, and we performed PTA because the patient experienced resistance to antiplatelet drugs and had poor collateral flow.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23427","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T19:48:37Z","timestamp":1698090517000},"source":"Crossref","is-referenced-by-count":3,"title":["Percutaneous transluminal angioplasty for persistent primitive hypoglossal artery stenosis: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Katsuma","family":"Iwaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Arimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunichi","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soh","family":"Takagishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Kurogi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniyuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Nakamizo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kyushu University, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Eur Radiol","first-page":"1492","article-title":"Primitive hypoglossal artery: demonstration with digital subtraction-, MR- and CT angiography","volume":"7","author":"Oelerich M","year":"1997","unstructured":"Oelerich M, Schuierer G. Primitive hypoglossal artery: demonstration with digital subtraction-, MR- and CT angiography. Eur Radiol. 1997;7(9):1492\u20131494."},{"issue":"2","key":"b2","series-title":"J Stroke","first-page":"144","article-title":"A functional perspective on the embryology and anatomy of the cerebral blood supply","volume":"17","author":"Menshawi K","year":"2015","unstructured":"Menshawi K, Mohr JP, Gutierrez J. A functional perspective on the embryology and anatomy of the cerebral blood supply. J Stroke. 2015;17(2):144\u2013158."},{"issue":"6","key":"b3","series-title":"J Vasc Surg","first-page":"1066","article-title":"Surgical revascularization in the presence of a preserved primitive carotid-basilar communication","volume":"41","author":"Thayer WP","year":"2005","unstructured":"Thayer WP, Gaughen JR, Harthun NL. Surgical revascularization in the presence of a preserved primitive carotid-basilar communication. J Vasc Surg. 2005;41(6):1066\u20131069."},{"issue":"1","key":"b4","series-title":"J Vasc Surg","first-page":"237","article-title":"Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection","volume":"63","author":"Zhang L","year":"2016","unstructured":"Zhang L, Song G, Chen L, Jiao L, Chen Y, Wang Y. Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection. J Vasc Surg. 2016;63(1):237\u2013240."},{"issue":"2","key":"b5","series-title":"Neurol Med Chir (Tokyo)","first-page":"104","article-title":"Endarterectomy for persistent primitive hypoglossal artery--case report","volume":"31","author":"Sunada I","year":"1991","unstructured":"Sunada I, Yamamoto S, Matsuoka Y, Nishimura S. Endarterectomy for persistent primitive hypoglossal artery--case report. Neurol Med Chir (Tokyo). 1991;31(2):104\u2013108."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"669","article-title":"Carotid endarterectomy in the presence of a persistent hypoglossal artery: case report","volume":"41","author":"Megyesi JF","year":"1997","unstructured":"Megyesi JF, Findlay JM, Sherlock RA. Carotid endarterectomy in the presence of a persistent hypoglossal artery: case report. Neurosurgery. 1997;41(3):669\u2013672."},{"issue":"5","key":"b7","series-title":"Neurol Med Chir (Tokyo)","first-page":"372","article-title":"Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report","volume":"39","author":"Hatayama T","year":"1999","unstructured":"Hatayama T, Yamane K, Shima T, Okada Y, Nishida M. Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report. Neurol Med Chir (Tokyo). 1999;39(5):372\u2013375."},{"issue":"5-6","key":"b8","series-title":"Minim Invasive Neurosurg","first-page":"263","article-title":"Carotid endarterectomy for internal carotid artery stenosis associated with persistent primitive hypoglossal artery: efficacy of intraoperative multi-modality monitoring","volume":"52","author":"Kawabori M","year":"2009","unstructured":"Kawabori M, Kuroda S, Yasuda H,  Carotid endarterectomy for internal carotid artery stenosis associated with persistent primitive hypoglossal artery: efficacy of intraoperative multi-modality monitoring. Minim Invasive Neurosurg. 2009;52(5-6):263\u2013266."},{"issue":"2","key":"b9","series-title":"J Vasc Surg Cases Innov Tech","first-page":"177","article-title":"Critical carotid artery stenosis involving a persistent primitive hypoglossal artery","volume":"6","author":"Pride LB","year":"2020","unstructured":"Pride LB, Lagergren ER, Hafner DH, Chervu AA. 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Minim Invasive Neurosurg. 2008;51(5):298\u2013302."},{"issue":"10","key":"b15","series-title":"Neurol Med Chir (Tokyo)","first-page":"921","article-title":"Carotid artery stenting in a patient with internal carotid artery stenosis and ipsilateral persistent primitive hypoglossal artery presenting with transient ischemia of the vertebrobasilar system: case report","volume":"50","author":"Nii K","year":"2010","unstructured":"Nii K, Aikawa H, Tsutsumi M,  Carotid artery stenting in a patient with internal carotid artery stenosis and ipsilateral persistent primitive hypoglossal artery presenting with transient ischemia of the vertebrobasilar system: case report. 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Vasc Endovascular Surg. 2023;57(8):919\u2013922."},{"issue":"1","key":"b22","series-title":"J Vasc Surg","first-page":"119","article-title":"Carotid artery stenting has increased risk of external carotid artery occlusion compared with carotid endarterectomy","volume":"61","author":"Brown K","year":"2015","unstructured":"Brown K, Itum DS, Preiss J,  Carotid artery stenting has increased risk of external carotid artery occlusion compared with carotid endarterectomy. J Vasc Surg. 2015;61(1):119\u2013124."},{"issue":"9","key":"b1","series-title":"Eur Radiol","first-page":"1492","article-title":"Primitive hypoglossal artery: demonstration with digital subtraction-, MR- and CT angiography","volume":"7","author":"Oelerich M","year":"1997","unstructured":"Oelerich M, Schuierer G. Primitive hypoglossal artery: demonstration with digital subtraction-, MR- and CT angiography. Eur Radiol. 1997;7(9):1492\u20131494."},{"issue":"2","key":"b2","series-title":"J Stroke","first-page":"144","article-title":"A functional perspective on the embryology and anatomy of the cerebral blood supply","volume":"17","author":"Menshawi K","year":"2015","unstructured":"Menshawi K, Mohr JP, Gutierrez J. A functional perspective on the embryology and anatomy of the cerebral blood supply. J Stroke. 2015;17(2):144\u2013158."},{"issue":"6","key":"b3","series-title":"J Vasc Surg","first-page":"1066","article-title":"Surgical revascularization in the presence of a preserved primitive carotid-basilar communication","volume":"41","author":"Thayer WP","year":"2005","unstructured":"Thayer WP, Gaughen JR, Harthun NL. Surgical revascularization in the presence of a preserved primitive carotid-basilar communication. J Vasc Surg. 2005;41(6):1066\u20131069."},{"issue":"1","key":"b4","series-title":"J Vasc Surg","first-page":"237","article-title":"Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection","volume":"63","author":"Zhang L","year":"2016","unstructured":"Zhang L, Song G, Chen L, Jiao L, Chen Y, Wang Y. Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection. J Vasc Surg. 2016;63(1):237\u2013240."},{"issue":"2","key":"b5","series-title":"Neurol Med Chir (Tokyo)","first-page":"104","article-title":"Endarterectomy for persistent primitive hypoglossal artery--case report","volume":"31","author":"Sunada I","year":"1991","unstructured":"Sunada I, Yamamoto S, Matsuoka Y, Nishimura S. Endarterectomy for persistent primitive hypoglossal artery--case report. Neurol Med Chir (Tokyo). 1991;31(2):104\u2013108."},{"issue":"3","key":"b6","series-title":"Neurosurgery","first-page":"669","article-title":"Carotid endarterectomy in the presence of a persistent hypoglossal artery: case report","volume":"41","author":"Megyesi JF","year":"1997","unstructured":"Megyesi JF, Findlay JM, Sherlock RA. Carotid endarterectomy in the presence of a persistent hypoglossal artery: case report. Neurosurgery. 1997;41(3):669\u2013672."},{"issue":"5","key":"b7","series-title":"Neurol Med Chir (Tokyo)","first-page":"372","article-title":"Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report","volume":"39","author":"Hatayama T","year":"1999","unstructured":"Hatayama T, Yamane K, Shima T, Okada Y, Nishida M. Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report. 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J Stroke Cerebrovasc Dis. 2021;30(11):106099."},{"issue":"8","key":"b11","series-title":"J Surg Case Rep","first-page":"rjab362","article-title":"A case of carotid endarterectomy assisted with a three-way junction shunting tube for the internal carotid artery stenosis involving a persistent primitive hypoglossal artery","volume":"2021","author":"Sanada T","year":"2021","unstructured":"Sanada T, Shirai W, Yamamoto S, Kinoshita M, Tokumitsu N. A case of carotid endarterectomy assisted with a three-way junction shunting tube for the internal carotid artery stenosis involving a persistent primitive hypoglossal artery. 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BMJ Case Rep. 2013;2013:bcr2012010578."},{"issue":"2","key":"b18","series-title":"Neuroradiol J","first-page":"115","article-title":"Internal carotid artery stenosis with persistent primitive hypoglossal artery treated with carotid artery stenting: a case report and literature review","volume":"29","author":"Ryu B","year":"2016","unstructured":"Ryu B, Ishikawa T, Hashimoto K,  Internal carotid artery stenosis with persistent primitive hypoglossal artery treated with carotid artery stenting: a case report and literature review. 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