Neurosurgical And Endovascular Treatment Of Intracranial Multiple Aneurysms

OBJECTIVE To discuss the clinic features of multiple intracranial aneurysms, and summarize the micro-neurosurgical result and experience.METHODS The clinical materials of 243 cases of clipping aneurysms during 2005. 3-2007.7 were retrospectively reviewed. Among them, there were 23 cases with multiple intracranial aneurysms(MIA) in which 52 were saccularaneurysms. While another23 patients with single intracranial aneurysms were chosen as control group randomly in the same period. Then the clinic data from both groups were analyzed and compared. RESULTS The occurring rate of MIA in all aneurysms was 9. 4%. In MIA group, the male-to-female ratio was 1:1.9, lower than SIA group's 1:1.3 (P<0. 05). 56.5% patients in MIA group had a history of smoking, higher than 34.8% patients in SIA group (P<0.05). Subarachnoid hemorrhage was the most common clinical sign of both groups. In MIA group, one-stage operations were performed in 9 cases, other 3 cases adopted one-stageoperations.In the postoperative follow-up by Orz's criterion, 17(73.9%) were free of neurological deficit or capable of leading an independent life (excellent or good), 6 cases were not independent and needed to be assisted (fair). In SIA group, one-stage operations were performed in 12 cases, other 2 cases adopted one-stageoperations. In the postoperative follow-up, 19 (82.6%) were free of neurological deficit or capable of leading an independent life (excelent or good), 4 cases were not independent and needed to be assisted (fair). There were no significant differences in age, history of hypertension, and postoperative recovery grade between both groups (P>0. 05) . The postoperative recovery grade had a correlation with preoperative Hunt-Hess grade(P<0. 05).CONCLUSIONS Compared to single intracranial aneurysms, the treatment of multiple intracranial aneurysms is a much more complicated work. According patients'preoperative condition and characteristics of multiple aneurysms, we recommend clipping all ruptured aneurysms as well as other aneurysms in one-stage operations. Only In some cases where one-stage operations cannot be achieved, the two-stage operations may be recruited.