Combined Neurosurgical and Endovascular Management of Complicated Skull Base Cerebral Aneurysms In Emergency Center

Abstract

Abstract Introduction: Intracranial aneurysms are the main caus of subarachnoid haemorrhage. Most patients with ruptured aneurysms are between 30 and 60 years of age, and the mortality rate is about 50% in the first month after the rupture. Diagnosis and treatment of multiple brain aneurysms still vary from institutions, physicians and individual patients, lacking a defined course of differential diagnosis, risk of rupture and rebleed evaluation and treatment. For multiple intracranial aneurysms, there are currently no unanimous and infallible guidelines for assessing the risk of rupture, recurrent bleeding, or harmonized treatment methods. Aim: To show the prevalence of multiple aneurysms in the population presenting to the Emergency Center and potentially indicate the right modality of treatment. Material and methods: The study included 304 patients who were treated for neuroradiologically verified cerebrovascular aneurysms in the Emergency Center of the University Clinical Center of Serbia, Belgrade. Results: Out of a total of 304 patients diagnosed with intracranial aneurysms, 85 (27,97%) patients were diagnosed with multiple intracranial aneurysms, 85,9% female, 14,1% male. Two aneurysms were recorded in 52 patients (61,2%), 18 patients (21,2%) had 3 aneurysms, 9 patients (10,9%) had 4 aneurysms, and 6 patients (7,06%) were diagnosed with 5 or more aneurysms. Conslusion: Multiple intracranial aneurysms in our study were present predominantly amongst women. The most frequent localization is ACI followed by ACM, ACoA, AB, while the other arteries were represented in to a very small number of respondents. Endovascular treatment methods are the most prevalent.