Multiple cerebral aneurysms of middle cerebral artery: Case report

Abstract

Multiple cerebral aneurysms present a wide variation in incidence with averages of 13% at angiographic studies and 22.7% at autopsy. 
High blood pressue, cigarette smoking, stress and possible also age and female sex seem to be risk factors for multiple intracranial aneurysms (MIAn) in patients of working age who have suffered a subarachnoid hemorrhage (SAH). Aneurysms were situated on the same side in one-third of the patients with two aneurysms and the most common site was the middle cerebral artery (MCA). To manage these challenging lesions neurosurgeons must use all available innovations and advances, including diagnostic, technical and perioperative adjuncts. The author presents a case of middle age female, with two saccular aneurysms situated on the same side (right MCA), who was operated in our clinic, 20 days after first SAH episode, I grade on Hunt/Hess scale. The angio MRI was performed before, and control DS angiography after operation. After pterional approach, the author used the magnification, microsurgical technics, temporal clip, and two permanent Yasargil curved clips. A postoperative good recovery enable the patient go to work and drive one month later.