(DISCLAIMER: This article is for scientific purposes only, and the information in the following content has been processed to protect patient privacy) Abstract: This case presents a 46-year-old female patient who presented to the emergency department with a sudden onset of dizziness and headache for 4 hours. The patient underwent head CT in the emergency department suggesting subarachnoid hemorrhage. After admission to the hospital, head and neck CTA was perfected, suggesting carotid aneurysm. Because of the patient’s critical condition, total cerebral arteriography + aneurysm intervention embolization was performed in the emergency room. After the operation, the patient was admitted to the intensive care unit for symptomatic treatment, and was discharged from the hospital after 10 days with good recovery. Basic information] Female, 46 years old [Disease type] Carotid aneurysm [Hospital] Liaoning Provincial People’s Hospital [Time of consultation] May 2022 [Treatment plan] Cerebral arteriography + aneurysm interventional embolization [Period of treatment] Hospitalization for 10 days [Effect of treatment] The patient’s dizziness and headache disappeared after the operation. In May 2022, a 46-year-old woman came to the emergency room of our hospital with a complaint of sudden onset of dizziness and headache for 4 hours. The patient had a sudden onset of dizziness and headache, neck pain, nausea and vomiting without any obvious triggers 4 hours before, and the vomit was food. A head CT was performed in the emergency department, suggesting subarachnoid hemorrhage. Head and neck CTA was performed, suggesting right internal carotid artery aneurysm. When the patient came to the emergency room, he was still in a clear state of mind, fluent in speech, and cooperative in physical examination. There was no history of hypertension, diabetes mellitus, heart disease, pulmonary or renal disease. Physical examination: bilateral pupils were equal in size and round, with a diameter of about 2.5 mm; direct and indirect light reflexes were sensitive; eye movements in all directions were free; there was no nystagmus; corneal reflexes were sensitive. The muscle strength of the limbs was grade 5, bilateral baroreflex sign was negative, and cervical tonus was positive. He was initially diagnosed as carotid aneurysm and was admitted to the ward. Considering that the sudden cerebral hemorrhage of the patient was related to the rupture of the aneurysm, due to the emergency condition of the patient, in order to prevent the further rupture of the aneurysm causing secondary hemorrhage, with the consent of the patient and his family, the patient underwent total cerebral arteriography + aneurysm intervention embolization under general anesthesia in an emergency, and a right internal carotid aneurysm of about 3.4×3.4 mm was seen in intra-operative imaging, and an appropriate spring ring was selected to fill in the aneurysm. The patient’s surgery went smoothly and he was admitted to the neurosurgical intensive care unit after the operation. The patient did not experience any complications such as reissue of blood, embolization, or increased intracranial pressure after the operation. Third, the treatment effect The patient’s surgical treatment effect was remarkable, postoperative dizziness, headache symptoms obviously disappeared, after 10 days of postoperative observation in the intensive care unit, the patient said that the pain symptoms completely disappeared, there were no other uncomfortable symptoms, and the vital signs were stable. In addition, postoperative imaging showed that the aneurysm was densely packed, the aneurysm-carrying artery was smooth, and the repeat head CT suggested that the subarachnoid hemorrhage was significantly absorbed compared with the previous one, and the patient complained of no obvious discomfort, so he was discharged from the hospital. Precautions It is gratifying that the patient’s condition improved effectively after surgery, but it is recommended that the patient should pay attention to the long-term oral antiplatelet drugs after carotid artery tumor surgery, so it is necessary to pay attention to the phenomena such as hematuria, hematochezia, coughing up blood, etc., and to pay attention to the skin to see if there are any bleeding spots, and if the above situation occurs, it is necessary to consult the doctor as soon as possible, and the dosage should be reduced according to doctor’s advice. Carotid artery tumor needs regular review after surgery, and also pay attention to the occurrence of other intracranial artery aneurysms, therefore, it is suggested that regular follow-up is needed after surgery, and at least one review of arteriography every year, and also a review of CTA of the head and neck. V. Personal perception Carotid artery aneurysm of intracranial segments is an important cause of intracranial hemorrhage, and the vast majority of the patients do not have any obvious symptom before an aneurysm is ruptured, but even if the aneurysm is too small, it needs to be Regular follow-up observation, once the aneurysm rupture, it is likely to be able to endanger the life, therefore, as the patient in the case, found that once there is dizziness and headache, violent vomiting and other symptoms, consider the aneurysm rupture, should be promptly to the hospital, to avoid aggravation of the condition. In addition, for such patients, after the diagnosis of aneurysm, to be limited to surgical treatment, in the pending surgery, must also pay attention to control blood pressure, the best blood pressure control at 120/80mmHg below.