Surgical treatment of multiple intracranial aneurysms

To discuss the surgical methods for multiple intracranial aneurysms.

23 patients were divided into three groups according to the location of the aneurysms: aneurysms located in one side or in the midline of the Willis ring; aneurysms located on both sides of the Willis ring with unruptured aneurysms located ahead of the middle cerebral artery bifurcation; and MIAs located on both sides with unruptured aneurysms located in the middle cerebral artery bifurcation or distal bifurcation. The preoperative operation strategy was made according to different groups.

All patients in the first group underwent a one-stage operation for occlusion of all aneurysms. In the second group, eight patients underwent a one-stage operation for occlusion of all arterial aneurysms while the other three patients underwent a one-stage operation for occlusion of the ipsilateral aneurysms, followed by a two-stage operation for occlusion of the contralateral arterial aneurysms. In the third group, all patients underwent a two-stage operation for occlusion of all aneurysms. Good recovery, moderate disability, and severe disability were observed in 19, 2, and 2 cases, respectively.

One-stage or two-stage surgery was determined based on the distribution of multiple aneurysms and the intraoperative situation to achieve ideal treatment effects.