Outcomes of treatment for multiple cerebral aneurysms

Abstract

Purpose: to analyze the outcomes of treating the acute phase of subarachnoid hemorrhage (SAH) depending on the number of multiple cerebral aneurysms (MCA). Materials and methods. The study included medical records of 89 patients divided into two groups: group 1 included patients with two arterial aneurysms (AAs), while group 2 consisted of patients with three or more AAs. Results. In the overall cohort, as well as in the group 1, surgical treatment significantly reduced the risk of mortality (overall cohort: Fisher’s exact test p = 0,008; group 1: Fisher’s exact test p = 0,011). However, surgical treatment did not demonstrate a statistically significant effect on other treatment outcomes. Notably, even patients presenting with a substantial burden of MCA could achieve favourable clinical outcomes following surgical intervention, with either no neurological deficit or only minimal residual impairment. However, the choice of treatment modality did not have a statistically significant influence on achieving any specific clinical outcome in the group 2 (Fisher’s exact test p = 0,248). Conclusions. Overall, a higher number of AAs did not significantly affect in-hospital treatment outcomes. Surgical treatment in the group 1 significantly reduced the risk of mortality compared to the group 2. Patients with a high burden of AAs require individualised approaches and combined treatment strategies due to an increased risk of complications. The limited number of observations highlights the need for further research to optimise treatment strategies and mitigate the risk of complications.