De-novo headache with transient vertebro-basilar symptoms: role of embryonic hypoglossal artery

The Journal of Headache and Pain

Brief Report

Angelo Maurizio Clerici¹  Camilla Micieli¹  Giorgio Bono¹  Giuseppina Cafasso¹  Giuseppe Craparo² 

[1] Neurology Unit, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Viale Borri 57, 21100, Varese, Italy;Neuroradiology Unit, Ospedale di Circolo e Fondazione Macchi, Viale Borri 57, 21100, Varese, Italy;

关键词: Persistent primitive hypoglossal artery;    Acute headache;    Carotid-basilar anastomosis;    Transient ischemic attack;    Vertebro-basilar system;   

DOI  :  10.1007/s10194-011-0394-5

 received in 2011-09-07, accepted in 2011-10-05,  发布年份 2011

来源: Springer

【 摘 要 】

We report the case of a 56-year-old man with acute onset of de-novo stabbing, pulsating and diffuse headache with subsequent appearance (within few minutes) of posterior fossa symptoms (vomiting, postural instability, anisocoria, incoordination, dysarthria, retropulsion) lasting 9–12 h. Recurrent hypertensive crises were detected during the acute observation in the Emergency Room, even in the absence of previous history of hypertension. Once subarachnoid hemorrhage and focal lesions (vascular and non-vascular) were excluded, brain computerized tomography-angiography and digital subtraction angiography disclosed the presence of left persistent primitive hypoglossal artery with bilateral vertebral artery hypoplasia and a slight aneurysmal dilation of the anterior communicating artery. Brain magnetic resonance study performed 24 h after onset of symptoms was negative for recent ischemic lesions. The clinical features of this rare vascular condition are discussed as a possible cause of magnetic resonance (diffusion weighted imaging) negative vertebro-basilar transient ischemic attack.

【 授权许可】

CC BY   
© The Author(s) 2011