Microsurgical treatment for multiple intracranial aneurysms of the anterior circulation

Objective To study the surgical strategy in multiple intracranial aneurysms of the anterior circulation and the effect of microsurgery on this kind of intracranial aneurysms and factors influential in prognosis. Methods A retrospective analysis was made on clinical factors and surgical outcome of patients who had multiple intracranial aneurysms of the anterior circulation during the years 2000 to 2004. The patients were classified into 2 groups according to the location of the aneurysms: multiple aneurysms locating unilaterally in the anterior circulation (group 1,14 cases) and locating bilaterally (group 2,9 cases). Results Among 162 patients with intracranial aneurysms,there were 23 with multiple aneurysms of the anterior circulation (14.2%) and 52 sacs: 18 with 2 aneurysms,4 patients 3 aneurysms,and 1 patient 4 and more. 100% of the lesions in group 1,70% in group 2 were clipped in one operation. Postoperative follow-up showed that 79% of these patients had a complete recovery. Conclusion If possible,all multiple aneurysms should be treated surgically in one stage or multiple sessions. The patient’s age,preoperative Hunt and Hess grade,the location and size of the aneurysms were significant factors in the clinical prognosis.