ABSTRACT
Introduction: Little is known about incidence, anatomical and clinical characteristics and results of endovascular treatment of the internal carotid artery (ICA) aneurysms. This type of the aneurysms can be approached by surgical with low morbidity and mortality. Clinical presentation: a 48-year-old woman submitted an endovascular embolization treatment in 2005, and in 2009 presents a new bleeding. The angiography shows that the same aneurysm was ruptured and a surgical repair was proposed. The surgical management shows detachable coils in the brain parenchyma. Conclusion: Some endovascular surgeons preferred the less invasive procedure (endovascular treatment) for intracranial aneurysms, but the surgical repair still remains the best choice for definitive treatment for intracranial aneurysms.