Clinical Analysis of Multiple Intracranial Aneurysms

ABSTRACT

A retrospective review of 54 patients with multiple intracranial aneurysms seen over a 5 year period was performed. Among the 252 patients with aneurysms, the incidence of multiple aneurysms was 21.4%. Multiple aneurysms were slightly more common in women with a female to male ratio of 1.351. But there was no different ratio for patients with three or more aneurysms. Common clinical features were headache(96%), meningeal sign(83%), and change of consciousness level(52%). The most common Fisher's grade was III(63%), according to brain CT finding. Common locations of multiple aneurysms were the PcomA(35.7%), MCA(24.8%), AcomA(17.8%), and ICA bifurcation(7.7%). However, the aneurismal locations with the highest incidence of rupture were the MCA(53.1%). AcomA(52.1%), basilar bifurcation(50%). The PcomA(34.7%) was the least likely site for rupture. On the distribution of multiple aneurysms according to location, unilateral and midline located multiple aneurysms were 49%. Size was more important than irregularity of the shape in identifying the site of rupture. Most ruptured aneurysms were 5mm or larger in size. Postoperative mortality was 4.4% and the most common cause of postoperative mortality was cerebral vasoapasm.