Bilateral persistent primitive hypoglossal artery presenting with hemiplegia✰

The manuscript describes an unusual vascular anomaly. Persistence of carotid-vertebrobasilar anastomosis is a rare occurrence with presence of bilateral hypoglossal arteries (HAs) rarer still. We present a case of bilateral persistent HAs with hypoplastic vertebral arteries which end into posterior inferior cerebellar arteries. The computed tomography and magnetic resonance imaging appearance, course, and other associations are discussed. A review of 6 cases of bilateral HA published in the world literature is also discussed.