open access

Vol 52, No 1 (2018)
Original research articles
Submitted: 2017-05-11
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Clinical outcomes of multiple aneurysms microsurgical clipping: Evaluation of 90 patients

Murad Asiltürk, Anas Abdallah
DOI: 10.1016/j.pjnns.2017.09.005
·
Neurol Neurochir Pol 2018;52(1):15-24.

open access

Vol 52, No 1 (2018)
Original research articles
Submitted: 2017-05-11

Abstract

Background

The incidence of multiple intracranial aneurysms (MIAs) among patients who are diagnosed with aneurysm is 15–45% in the literature. Treatment options depend on the patient's status, age, aneurysm location and neurosurgeon's experience. In this study outcomes of micro-surgically clipped 90 patients have been evaluated.

Materials and methods

Medical records of 90 (49 women and 41 men) patients of MIAs who underwent surgery by the authors, during a 3-year period from 2011 to 2013 were retrospectively reviewed of prospectively collected patients’ data. Surgically treated patients underwent a lateral supraorbital craniotomy followed by microsurgical clipping of all reachable aneurysms.

Results

The mean age of the sample is 50.8±11.9 (25–82) years. There were 67 patients presented with SAH. The most common complaint was severe headache of sudden onset (94%) in SAH group and migraine type headache (60.8%) in incidentally diagnosed group. According to location of the arteries; ACoA (50), MCA (R:49,L:45), ICA (R:34,L:15), PCoA (R:9,L:4), ACA (R:6,L:4), basilar artery (3) and SCA (2). Mortality rate was 13.3% (n=12), morbidity rate (new deficit was developed) was 18.8% (n=17) [7 out of them were partially/completely dependent on others for daily living activities before surgery (i.e. GOS<3)] and 67.8% (n=61) of the patients returned to their normal jobs and daily activities.

Conclusions

Multiple cerebral aneurysms are not associated with a less favorable outcome than are single aneurysm cases. Authors prefer microsurgical clipping of all the aneurysms, be it on the reverse side, if the aneurysm location is reachable and that includes bilaterally presenting MIAs.

Abstract

Background

The incidence of multiple intracranial aneurysms (MIAs) among patients who are diagnosed with aneurysm is 15–45% in the literature. Treatment options depend on the patient's status, age, aneurysm location and neurosurgeon's experience. In this study outcomes of micro-surgically clipped 90 patients have been evaluated.

Materials and methods

Medical records of 90 (49 women and 41 men) patients of MIAs who underwent surgery by the authors, during a 3-year period from 2011 to 2013 were retrospectively reviewed of prospectively collected patients’ data. Surgically treated patients underwent a lateral supraorbital craniotomy followed by microsurgical clipping of all reachable aneurysms.

Results

The mean age of the sample is 50.8±11.9 (25–82) years. There were 67 patients presented with SAH. The most common complaint was severe headache of sudden onset (94%) in SAH group and migraine type headache (60.8%) in incidentally diagnosed group. According to location of the arteries; ACoA (50), MCA (R:49,L:45), ICA (R:34,L:15), PCoA (R:9,L:4), ACA (R:6,L:4), basilar artery (3) and SCA (2). Mortality rate was 13.3% (n=12), morbidity rate (new deficit was developed) was 18.8% (n=17) [7 out of them were partially/completely dependent on others for daily living activities before surgery (i.e. GOS<3)] and 67.8% (n=61) of the patients returned to their normal jobs and daily activities.

Conclusions

Multiple cerebral aneurysms are not associated with a less favorable outcome than are single aneurysm cases. Authors prefer microsurgical clipping of all the aneurysms, be it on the reverse side, if the aneurysm location is reachable and that includes bilaterally presenting MIAs.

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Keywords

Multiple cerebral aneurysm clipping, Subarachnoid hemorrhage, Hunt–Hess scale, Counter laterally clipping aneurysm, Extensive drilling in aneurysm surgery

About this article
Title

Clinical outcomes of multiple aneurysms microsurgical clipping: Evaluation of 90 patients

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 52, No 1 (2018)

Pages

15-24

DOI

10.1016/j.pjnns.2017.09.005

Bibliographic record

Neurol Neurochir Pol 2018;52(1):15-24.

Keywords

Multiple cerebral aneurysm clipping
Subarachnoid hemorrhage
Hunt–Hess scale
Counter laterally clipping aneurysm
Extensive drilling in aneurysm surgery

Authors

Murad Asiltürk
Anas Abdallah

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