Skorokhoda I. Multiple cerebral arterial aneurysms: diagnostic and surgical treatment.

Dissertation is devoted to the problem of diagnostic and surgical treatment of multiple cerebral arterial aneurysms. In order to make decision about the origin of hemorrhage after aneurysm's rupture, we made the complex of clinical and instrumental investigations and planned the algorithm. Clinical material is represented by 291 observations of patients with multiple cerebral arterial aneurysms, who have been treated in the clinic of cerebral arterial pathology of Institute of neurosurgery from 1997 till 2006. Surgical treatment was made for 282 patients (96.9%), among them 163 patients (57.8%) with multiple cerebral arterial aneurysms were operated during first two weeks. We observed the size, localization, and complex of arterial aneurysms for making decision about the origin of hemorrhage, made classification of multiple aneurysms that was important for the choice of surgical management for optimal simultaneous operative treatment (60.3%). Transcranial management was applied to 89.4%, endovascular -6.7%, combined - 3.9% patients. In general from blood circulation were occlused 589 (91.3%) aneurysms. Good and satisfactory treatment results were obtained in 84.4 % patients. Decreasing of postoperative mortality (from 21.4% in 1998 year to 6.5% in 2005-2006 years) became possible due to the improvement of surgical methodics and acquired experience of surgical treatment of such patients. Results of surgical treatment patients with multiple aneurysms depend on severeness of condition, accompanied somatic diseases, terms of operative management after hemorrhages, their amount, complications after the rupture of the aneurysm. The results of scientific research were embodied in neurosurgery practice.