Rationale: Persistent primitive hypoglossal artery (PPHA) is often associated with intracranial anomalies such as aneurysms. Surgical treatment of aneurysms on the PPHA is challenging due to that the posterior circulation depends solely on PPHA.
Patient concerns: A case of an 83-year-old woman with a large aneurysm on PPHA presented with vertigo was reported.
Diagnosis: Three-dimensional angiogram revealed a wide-neck aneurysm on the PPHA.
Interventions: The aneurysm was successfully treated using a novel low-profile visualized intraluminal support stent-assisted coiling technique.
Outcomes: No complications occurred during the procedure. The final angiogram confirmed the patency of the posterior inferior cerebellar artery and the parent artery and its distal branches.
Lessons: Our case suggests that stent-assisted coil embolization is safe and effective for the treatment of aneurysms on the PPHA.