Abstract
The occurrence of multiple intracranial aneurysms (MIAs) is not rare, with a reported
incidence of 15 to 35%. However, patients harboring seven or more intracranial aneurysms
are so uncommon that only sporadic cases have ever been reported. We present a rare
case with seven intracranial aneurysms (two anterior communicating artery aneurysms,
two right middle cerebral artery aneurysms, two left ophthalmic artery aneurysms,
and one right ophthalmic artery aneurysm) in the anterior circulation that were simultaneously
clipped via the extended right pterional approach. The surgery was uneventful. The
patient experienced a rapid postoperative recovery with no neurologic deficits. To
our knowledge, this is the first case of seven bilateral intracranial aneurysms that
were surgically clipped via unilateral craniotomy. This case showed that in properly
selected patients with anterior circulation MIAs, even as many as seven, one-stage
clipping can be achieved. Successful clipping of the contralateral ophthalmic aneurysms
was the key step in the operation.
Keywords pterional approach - anterior circulation - multiple intracranial aneurysms - clipping
