Surgical Treatment Strategy and Perioperative Analysis of Patients With Intracranial Mirror Aneurysms

OBJECT: Intracranial mirror aneurysm is a type of multiple aneurysms, which is rare in clinical and literature. There is no unified conclusion on the treatment strategy of mirror aneurysms. Therefore, our study evaluated the surgical approach and prognosis of a series of mirror aneurysms, and explored the clinical features and treatment strategies of mirror aneurysms. METHODS: This study retrospectively analyzed the clinical features, imaging data, treatment methods and post-hospital results of 67 cases of mirror aneurysms admitted to our department from December 1997 to April 2018. RESULTS: There were 20 males and 47 females with an average age of 53.6 years. Mirror aneurysms are mainly located in the posterior communicating artery and middle cerebral artery. Of 67 patients, 1-stage unilateral craniotomy with bilateral aneurysms in 18 cases, 1-stage bilateral craniotomy with bilateral aneurysms in 17 cases, staged treatment of bilateral aneurysms in 13 cases, and 19 cases only treated the responsible aneurysms. 57 cases with good recovery; 7 cases were self-care; 1 case was heavy disability; 2 cases were dead. In parallel, 8 cases had different degrees of cerebral infarction, 3 cases of hydrocephalus, 3 cases of oculomotor nerve injury, 2 cases died of cerebral hernia resulted from intracranial hypertension, and the remaining 53 cases were better. CONCLUSIONS: The treatment of the mirror aneurysm should be based on the location, size, shape of the aneurysm, the patient's clinical manifestations and the surgeon's experience to choose a personalized treatment.