The Stratege Of Diagnosis And Treatment For Multiple Intracranial Aneurysms

Objective To explore the methods to diagnose and treat multiple intracranial aneurysms.Methods Clinical data of 16 patients with multiple intracranial aneurysms,in whom 39 aneurysms were found,were analyzed retrospectively.There were 2 aneurysms in each of 13 patients,and 3 aneurysms were found in 2 patients,4 aneurysms in 1 patient,5 aneurysms in 1 patient.Of 10 patients undergoing operation clipping or endovascular treatment,4 cases were treated by one-stage and 6 by two-stage approach,12 aneurysms in 7 patients were treated by operation clipping,4 aneurysms underwent endovascular treatment,combined endovascular embolization with clipping aneurysms was performed in 1 patients,4 unruptured aneurysms were not treated.6 cases received conservative treatment among 6 patients,5 recovered well and 1 patient aggravated.Results 9 patients receiving the surgical or endovascular treatment were survived,one died.According to the Glasgow Outcome Scale(GOS),7 recovered well,one hemiparesis and one paralysis was observed.9 patients followed up from 3 months to 3 years averaged 14 months,6 patients who got conservative treatment 1 patient aggravated,4 patients lost to vist,1 paitent whose intracranial aneurysms located in the siphon of carotid artery followed up 13 months,Digital subtraction angiography was applied to recheck the multiple intracranial aneurysms and found that the shape of aneurysms did not change obviously.Conclusion Judge the ruptured aneurysm correctly and treat it firstly,the methods of treatment for multiple intracranial aneurysms were based on clinical features.Generally,according to the position the shape of the aneurysms and the clinical scale of Hunt-Hess,these patients were treated by operation clipping or endovascular treatment by one-stage or two-stage approach in order to get better outcome.