We would like to share a rare case of surgical treatment of 5 out of 6 aneurysms in a patient. The latter was admitted with symptoms of cerebral hemorrhage in a state of moderate severity with cognitive deficit without gross focal symptoms. During the examination, it was found that she had 6 saccular aneurysms of the cerebral vessels. In general, vascular aneurysms occur in 12 cases per 100,000 population. Multiple aneurysms account for approximately 30% of cases.

An aneurysm is an abnormal sac that forms in the wall of a blood vessel. Normally, the vascular wall has three layers, the middle one of which is muscular, which is the thickest. An aneurysm lacks this layer and the wall becomes thin and prone to rupture. With or without increased blood pressure, the aneurysm wall may rupture and bleed.

Multiple aneurysms pose a separate problem, as it is important to determine which one has ruptured, which way (open or endovascular) they should be operated on, whether to close them all at once or one at a time, and various other issues.

The surgical intervention is primarily aimed at preventing hemorrhage, which is much more severe than the first one. In addition, blood washing is performed, which can cause a very serious complication – vasospasm.

The operation was performed urgently. It was decided to perform clipping . Thus, 5 out of 6 aneurysms were clipped during the operation. One was left because it was in an anatomically difficult place and it was difficult to get it from one access.

There were no complications. The postoperative period was uneventful. After the operation, the patient continues treatment to restore cognitive functions.

Thanks to modern equipment and experience, the treatment of such complex cases is possible at the KNP TOKPNL TOR. The only unclamped aneurysm will be treated in the cold period after the patient’s recovery.

Thank you for your attention!

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Prepared by Alexey Leontiev