Analysis of surgical treatment for patients with multiple intracranial aneurysms

Objective To study the clinical effects of surgical treatment for patients with multiple intracranial aneurysms.Methods 45 patients with multiple intracranial aneurysms were treated with microsurgery.According to the Glasgow Coma Scale(GCS),31 were 13 to 15,10 were 8 to 12 and 4 were less than 8.Digital subtraction angiography(DSA)was applied to confirm the location of the multiple aneurysms preoperatively.CT scan was applied for diagnosis of ruptured aneurysm.Left or right pterion approach was chosen according to the location of aneurysms.Under microscope,36 cases with 68 aneurysms were clipped and 6 were wrapped in one stage and 3 cases with 6 aneurysms were clipped in two-stage operation.In 6 cases,only the ruptured aneurysms were treated.Results 80 aneurysms were clipped and 6 were wrapped.There was no operative mortality.1 patient died of heart failure,1 was lived in vegetative state,2 were hemiparalyzed and 2 out of 5 patients who had oculomotor nerve paralysis recovered after surgery.The GCS score of 38 patients were 13 to 15,6 were 8 to 12 and 1 was less than 8 postoperatively.(Conclusion) Clipping of multiple intracranial aneurysms in one-stage operation is recommended.Pterion approach is capable for treating most of multiple aneurysms,even if some locate on the bilateral side.Surgery plays an important role in the management of patients with multiple aneurysms.