Clinical Analysis of Multiple Intracranial Aneurysms

Kim, Sung Min; Kim, Dong Keun; Kim, Gook Ki; Lim, Young Jin; Kim, Tae Seoung; Rhee, Bong Arm; Leem, Won

Abstract

Mulitiple intracranial aneurysms occur in range of 15% to 30% of all patients with intracranial aneurysms. The treatment of such patients offers a particular challenge for the neurosurgeon. Early reports dealing with multiple aneurysms recommended treatment of only the ruptured aneurysm, but recently, authors have advised treatment of all significant aneurysms. We performed a retrospective review for 63 patients with multiple intracranial aneurysms, admitted to Department of Neurosurgery, Kyung-Hee University Hospital between Jun. 1982 and Dec. 1989. The present study includes the incidence of multiple aneurysms, its age and sex distribution, aneurysm locations, probability of rupture, relationship of aneurysmal size and rupture, and operative results. The results were as follows ; 1) Multiple intracranial aneurysms occurred in about 12.2% of all patient with aneurysms. 2) The female to male ratio was about 2.3:1 for patients with two aneurysms and 5:1 for patients with three or more aneurysms. 3) Common location for multiple aneurysms were the PCoA, ICA, ACoA, and MCA. 4) On the distribution of multiple aneurysms according to location, unilateral and midline located mutliple aneurysms were 61.9%. 5) Probability of aneurysmal rupture according to site was(in decreasing order) ACoA, PCoA, AChoA, MCA, and ICA bifurcation. 6) Irregularity of shape was more inportant than size in identifying the site of rupture. 7) Most unruptured aneurysms were 5mm or smaller in size ; however, most ruptured aneurysms were 6mm or larger. 8) About 70% of surgical management showed good and fair result.