Cerebralaneurysmscoexist with arteriovenousmalformations. In tandem arteriovenousmalformation and aneurysm, in the case of haemorrhage, itisoftendifficult to indicatewhichis the source ofbleeding.Thiscancausediagnosticdifficulties.We present a case of a 40-year-old patient with subarachnoid hemorrhage, occipital malformation and concomitantaneurysm of the ipsilateral posterior cerebral artery. After clinical and neuroimaging analysis, anddiagnostic deliberations, the source of bleeding turned out to be an aneurysm. This case is significant because the aneurysm was treated by surgical clipping, which is rare today. Intravascularcoilingis the treatment of choice for vertebrobasilaraneurysms. Due to the development of endovasculartechniques, clipping of suchaneurysmshasbecomehistoricmethod.We present a procedure of clippingthroughanextendedpterionalcraniotomy. We detail the nuanses, limitations, and potentialcomplications.We also pay attention to maintaining the diagnostic vigilance of indicating the source of bleeding in the event of coexisting aneurysm and malformation.