Case presentation: 28-year-old male, 40 days after a motorcycle traffic accident, presented with progressive right eye congestion and ocular protrusion with bulbar conjunctival edema and intracranial pulsating murmur. Cranial CT suggested thickening of the supraocular vein (Figure 1, red arrow); angiography showed complete steal of the right internal carotid artery, and the rupture of the internal carotid artery could be seen on vertebral arteriogram (Figure 2, red arrow); a small balloon filled the balloon after following the blood flow into the cavernous sinus (Figure 3, red arrow); re-imaging showed complete closure of the fistula and return of normal blood flow (Figure 4). The patient completely disappeared from all symptoms within one week after surgery. Huang Qinghai, Department of Neurosurgery, Shanghai Changhai Hospital