Despite the increasing reports of successful treatments for traumatic intracranial aneurysms, their characterization and the impact of concurrent head injuries on interventions aren't well explored.A traumatic anterior cerebral artery pseudoaneurysm with CSF leakage was successfully treated. The aneurysm was treated microsurgically, while the CSF leakage was managed through dural repair.Traumatic intracranial aneurysms may have strong aneurysm walls in the subacute stage, making microsurgical repair feasible. Concomitant skull base fractures and CSF rhinorrhea complicate treatment and should be carefully considered.© 2025. The Author(s).