Clinical Analysis of Multiple Intracranial Aneurysm

ABSTRACT

A retrospective review was performed of all patients with multiple intracranial aneurysms treated over a 6-year period. Fifty-three patients with a total of 121 aneurysms were included. Of all patients with aneurysms treated in same interval, the incidence of multiple aneurysms was 11.7%. Multiple aneurysms were much more common in women, with a male to female ratio of 13.1. The common locations for multiple aneurysms were posterior communicating artery(28.9%), middle cerebral artery(27.3%) and anterior communicating artery(14.0%). However, location with the highest probability of rupture was the anterior communicating artery(64.7%). In identifying the site of rupture, the presence of focal hematoma on brain CT scan, focal vasospasm, irregularity and size of aneurysmal sacs on angiograms were helpful. Direct operations were performed on all cases. Both the ruptured and unruptured aneurysms were treated in 42(79%) 3 cases, and the ruptured aneurysms only in 11(21%). Among 42 cases, treated for both ruptured and unruptured aneurysms, one-stage operations were performed in 28 cases, whereas two-stage operations were performed in 14 cases. Surgical outcome was favorable in 87% of the cases and mortality rate was 7.5%. The outcome was influenced by preoperative clinical status of the patients, but not by the locations of aneurysms or operative methods.