Cureus | De-novo headache with transient vertebro-basilar symptoms: role of embryonic hypoglossal artery
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Case Report

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

Angelo Maurizio Clerici, Giuseppe Craparo, Giuseppina Cafasso, Camilla Micieli, Giorgio Bono

Published: October 19, 2011

DOI: 10.1007/s10194-011-0394-5

License: © The Author(s) 2011

Abstract

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.


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Scholarly Impact Quotient™ (SIQ™)

Scholarly Impact Quotient™ (SIQ™) is our unique post-publication peer review rating process. SIQ™ assesses article importance and quality by embracing the collective intelligence of the Cureus community-at-large. All registered users are invited to contribute to the SIQ™ of any published article. (Authors cannot rate their own articles.)

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