case_images: PMC6194315_01
case_images: Diffusion-weighted magnetic resonance images showing acute infarcts involving the left corona radiate (A, arrowhead), bilateral cerebellar hemispheres and left pons (B, arrowheads).
case_images: fneur-09-00837-g0001.jpg
case_images: PMC6194315_01_fneur-09-00837-g0001.jpg
case_images: F1
case_images: Diffusion-weighted magnetic resonance imaging revealed acute multiterritorial infarcts in the left corona radiata, bilateral cerebellar hemispheres, and left pons (Figure 1).
case_images: Cervical color doppler ultrasonography revealing atherosclerotic plaques (A,B, arrowheads) of the left internal carotid artery.
case_images: fneur-09-00837-g0002.jpg
case_images: PMC6194315_01_fneur-09-00837-g0002.jpg
case_images: F2
case_images: Cervical color ultrasound examination demonstrated vulnerable atherosclerotic plaques at the origin of the left ICA (Figure 2), and bilateral low flow with a high resistance flow pattern in both vertebral arteries while normal flow in the basilar artery.
case_images: Computed tomography angiography showing an anomalous vessel (A, arrow) arising from the left internal carotid artery and then traveling through the left hypoglossal canal (B,C), consistent with the diagnosis of persistent hypoglossal artery. Note that bilateral vertebral arteries were hypoplastic (arrowheads), and no posterior communicating arteries were found; therefore, the PHA primarily fed the posterior circulation.
case_images: fneur-09-00837-g0003.jpg
case_images: PMC6194315_01_fneur-09-00837-g0003.jpg
case_images: F3
case_images: CT angiography of the head showed a left PHA, bilateral hypoplastic vertebral arteries, and no posterior communicating arteries (Figure 3).