Diagnosis and treatment of multiple intracranial aneurysms / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment strategy of multiple intracranial aneurysms (MIA).</p><p><b>METHODS</b>We retrospectively analyzed 96 patients with MIA (234 aneurysms). The rupture site was determined on the basis of computed tomographic and angiographic findings, and the supposed ruptured aneurysm was treated with coiling OR clipping. All the patients' records were reviewed including all computed tomographic scans and angiograms.</p><p><b>RESULTS</b>Twelve patients received conservative treatment, 56 patients were treated by endovascular embolization, and 28 patients received clipping; 44 patients received one-stage treatment, and 4 patients needed a second therapy. In 36 patients, only the ruptured aneurysm was eliminated. The clinical outcomes of these 84 patients evaluated by Glasgow Outcome Scale grades were absence of deficits in 62 patients, minor deficits in 12 patients, major deficit in 8 patients; death occurred in 2 cases. Thirty patients were available for a 6-month follow-up with DSA, which revealed stable occlusion of the aneurysms in 29 patients and the need of a retreatment due to recanalization in only one patient.</p><p><b>CONCLUSION</b>Correct localization of the rupture aneurysm based on a comprehensive diagnosis is key to MIA treatment. All the aneurysms should be treated in one session whenever possible to protect the patient from rebleeding.</p>