Ruptured aneurysm of a persistent primitive hypoglossal artery treated by endovascular approach—case report and literature review

BackgroundA persistent PHA is the second most common of the embryonic carotid-basilar anastomoses that fail to regress in the embryo. The fact that PHA often is functionally a single artery providing blood to the posterior circulation poses challenging therapeutic problems in case of an aneurysm located on the PHA.Case DescriptionA 46-year-old woman presented with SAH due to a large ruptured aneurysm of the left PHA. Identification of such an artery by CT angiogram is the proposed cold standard. The aneurysm was obliterated by coil embolization. To our knowledge, this is the first reported case of aneurysm located on a primitive persistent hypoglossal artery that was endovascularly treated.ConclusionAneurysms located on a persistent PHA can be treated safely and effectively via an endovascular approach.