{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:02:56Z","timestamp":1761897776640,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The primitive hypoglossal artery (PHA) is an anastomotic vessel of the carotid-basilar artery system that is prevalent only transiently during the embryonic period. Persistent primitive hypoglossal artery (PPHA) is a rare vessel variation in which PHA exists persistently in adulthood and occurs in approximately 0.02\u20130.1% of the population. Tortuosity of the extracranial internal carotid artery (ICA) is relatively common, impacting 10\u201343% of the population, and is caused by either congenital or acquired factors. It is still unknown whether PPHA and tortuosity of extracranial ICA are associated. Here, we present a case report of the concurrence of three types of pathologies of the carotid artery: extreme coiling of the extracranial internal carotid artery, multiple aneurysms and persistent primitive hypoglossal artery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>A 66-year-old woman suffered intermittent headaches, dizziness and numbness of the right eyelid for 5 years. Magnetic resonance angiography performed in a local hospital reported an aneurysm of the posterior communicating artery segment of the left ICA and a left PPHA. Digital subtraction angiography conducted after admission showed a PPHA originating from the left cervical ICA and an extremely coiling segment of the ICA distal to the beginning of PPHA. Except for the aneurysm of the posterior communicating artery segment of the left ICA, multiple aneurysms were found at the coiling segment of the ICA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To the best of our knowledge, this is the first report of PPHA accompanied by an adjacent, extremely coiling ICA. There are no reports of similar tortuous ICAs to this extent or at this position. Including aneurysms, three types of pathologies suggest their congenital origin, and a review of the literature infers the probable association of these lesions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.1053704","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T05:15:29Z","timestamp":1670217329000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Concurrence of multiple aneurysms, extreme coiling of the extracranial internal carotid artery and ipsilateral persistent primitive hypoglossal artery: A case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Zheng","family":"Wan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianyi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honglei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1053\/j.sult.2011.02.002","article-title":"Normal cerebral arterial development and variations","volume":"32","author":"Kathuria","year":"2011","journal-title":"Semin Ultrasound CT MR."},{"key":"B2","doi-asserted-by":"publisher","first-page":"621610","DOI":"10.3389\/fneur.2021.621610","article-title":"Case report: persistent primitive hypoglossal artery accompanied by a basilar bifurcation aneurysm treated by Y-stent-assisted coil embolization","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Neurol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.wneu.2018.06.119","article-title":"Fatal subarachnoid hemorrhage from an aneurysm of a persistent primitive hypoglossal artery: case series and literature overview","volume":"117","author":"Varvari","year":"2018","journal-title":"World Neurosurg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"168","DOI":"10.3389\/fneur.2017.00168","article-title":"A persistent primitive hypoglossal artery as the sole supply to the brain associated with a basilar bifurcation aneurysm","volume":"8","author":"Wang","year":"2017","journal-title":"Front Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1177\/197140090201500617","article-title":"Parietal arteriovenous malformation associated with ipsilateral persistent primitive hypoglossal artery: a case report","volume":"15","author":"Mori","year":"2002","journal-title":"Riv Neuroradiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3109\/02688697.2011.584983","article-title":"Endovascular treatment of AVM-associated aneurysm of anterior inferior cerebellar artery through persistent primitive hypoglossal artery","volume":"26","author":"Pavlisa","year":"2012","journal-title":"Br J Neurosurg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1159\/000050433","article-title":"Moyamoya disease associated with persistent primitive hypoglossal artery: report of a case","volume":"35","author":"Katayama","year":"2001","journal-title":"Pediatr Neurosurg."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e27875","DOI":"10.1097\/MD.0000000000027875","article-title":"Posterior fossa transient ischemic attack in the setting of bilateral persistent hypoglossal arteries: a case report and literature review","volume":"100","author":"Ren","year":"2021","journal-title":"Medicine (Baltimore)."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.03.026","article-title":"Stenting for internal carotid artery stenosis associated with persistent primitive hypoglossal artery using proximal flow blockade and distal protection system: a technical case report and literature review","volume":"25","author":"Murai","year":"2016","journal-title":"J Stroke Cerebrovasc Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/s00276-006-0149-1","article-title":"Kinking, coiling, and tortuosity of extracranial internal carotid artery: is it the effect of a metaplasia?","volume":"28","author":"La Barbera","year":"2006","journal-title":"Surg Radiol Anat."},{"key":"B11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1212\/WNL.15.1.7","article-title":"Tortuosity, coiling, and kinking of the internal carotid artery. 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