Persistent primitive hypoglossal artery with atrial septal defect.

A 66-year-old man was referred to our department for investigation prior to cardiac surgery on ASD. He had no complaints. On neurological examination, there were no abnormal symptoms. ASD was reconfirmed by ultrasonic cardiography and cardiac catheterization. Cardiac catheterization showed that the pulmonary-to-systemic flow ratio (Qp/Qs) was 2.49 and surgery was recommended. Because magnetic resonance angiography (MRA) showed an abnormal artery, catheter angiography was performed. Angiography revealed the abnormal artery left right ICA to be a large extracranial branch and the basilar trunk originated from the artery. CT revealed the right anterior condyloid foramen to be enlarged (Fig. 1). Therefore, the abnormal artery was thought to be PPHA. Cardiac surgery was successfully performed.