Objective To explore the efficacy of endovascular treatment and craniotomy for the blood blister-like aneurysm of the carotid artery.

Methods The clinical data of 6 patients with ruptured bullous aneurysms in the Department of Neurosurgery, the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from January 2018 to September 2020 were retrospectively analyzed, all patients had subarachnoid hemorrhage, and were given clip or craniotomy according to the actual situations. CTA of head and neck was reexamined 3 months after craniotomy, DSA was reexamined 6 months after endovascular treatment. Telephone or outpatient follow-up was performed and mRS score was evaluated every 3 months.

Results Among the 6 patients, 3 patients were given craniotomy clipping therapy and 3 patients were given endovascular interventional therapy. The mRS score was 0 in 3 cases, 1 in 2 cases, and 3 in 1 case. The follow-up time was 6-24 months. No recurrence or rebleeding was found in 6 patients with DSA or CTA.

Conclusions Both endovascular therapy and craniotomy clipping for the blood blister-like aneurysm of the carotid artery have high treatment risks. if reasonable treatment is given, better efficacy can still be achieved.