Risk of bleeding from unruptured aneurysms in cases with multiple intracranial aneurysms

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Abstract
Patients (61) with subarachnoid hemorrhage (SAH) and at least 2 intracranial artery aneurysms, in whom only the ruptured aneurysm was clipped, were studied. During a 10 yr follow-up period, 7 patients bled from a previously unruptured aneurysm; 4 of the hemorrhages were fatal. Three additional patients suffered fatal bleeding > 10 yr after the 1st SAH. The surgical mortality rate when operating on a ruptured aneurysm at this clinic was 4.2% in 1979. Considering that the mortality rate after rebleeding during an average follow-up period of 16 yr was 11.5%, operation for unruptured aneurysms seems to have a slight edge over conservative treatment.