[Multiple intracranial aneurysms in Camagüey, Cuba]

It is considered multiple intracranial aneurysms when a patient harbors two or more intracranial aneurysms.

To analyze clinical characteristic and microneurosurgical results of patients with multiple intracranial aneurysms attended in Camagüey.

Between 524 patients operated on to clip aneurysms, we searched 113 patients with multiple intracranial aneurysms. Patients were operated on by microneurosurgical methods and specialized neuroanesthesia. We performed one or two stage operations. Patients were evaluated three month later with Glasgow Outcome scale.

There were 21.5% of multiple aneurysms. Age average was 46 years. There were 85 (75%) women and 28 (25%) men. Associated diseases were high blood pressure, carotid fibromuscular dysplasia and familiar aneurysms. There were 264 aneurysms: 252 at the carotid system and 12 at the vertebrobasilar circulation. Sacs average per patients was 2.3. There were 36% of bilateral aneurysms and 30% of symmetric or mirror sacs. Nehls algorithm permitted to localize symptomatic lesions at: posterior communicating region, anterior cerebral anterior communicating artery, basilar bifurcation, ophthalmic region, and middle cerebral artery. We utilized 128 surgical procedures and two stage operations were applied in 15 patients. 90% of aneurysms were clipped. Ninety patients (79%) obtained complete recuperation, 15 (12%) partial incapacity; 3 (4%) severe incapacity and there were not vegetative patients. Five patients died and the mortality rate was 4.4%.

Multiple intracranial aneurysms are complex lesions but each one has a similar behavior to sporadic aneurysms. Association to different medical conditions is frequent and microneurosurgery offers good results.