Surgical Treatment Of Multiple Intracranial Aneurysms

OBJECTIVE To discuss the clinic features of multiple intracranial aneurysms, and summarize the micro-neurosurgical result and experience.METHOD The clinical materials of 126 cases of clipping intracranialaneurysms during 2004.9-2005.10 were retrospectively reviewed. Among them, there were 12 cases with multiple intracranial aneurysms (MIA) in which 24 were saccular aneurysms, 2 were fusiform aneurysms. While another 12 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 9.5%. In MIAgroup, the male-to-female ratio was 1:2, lower than SIA group's 1:1.4 (P<0.05). 75% patients in MIA group had a history of smoking, higher than 50% 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-stage operations. In the postoperative follow-up by Orz's criterion, 10 (83.3%) were free of neurological deficit or capable of leading an independent life (excellent or good), 2 cases were not independent and needed to be assisted (fair). In SIA group, one-stage operations were performed in all cases. In the postoperative follow-up, 11 (91.6%) were free of neurological deficit or capable of leading anindependent life (excellent or good), 1 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.CONCLUSIONS Compared to single intracranial aneurysms, thetreatment 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.