Abstract
This report outlines our pre-and intraoperative decision-making for a unilateral approach in patients with multiple, bilateral intracranial aneurysms. During the last 7 years, 41 patients with 116 bilaterally localized aneurysms were treated in our department by microsurgical clipping. In 18 patients (44%), a unilateral approach enabled a successful clip occlusion of the aneurysms. In 11 patients (27%), a unilateral approach was attempted and the contralateral aneurysm detected. However, intraoperative circumstances suggested not to clip and, consequently, a bilateral approach was chosen for safe and complete clipping. In 12 patients (29%), radiological and clinical features primarily advised a bilateral approach. There was no significant difference in the overall postoperative outcome in patients treated unilaterally versus bilaterally. No complications related to the unilateral surgical management occurred. We conclude on the basis of our experiences, that in selected cases the clipping of contralateral aneurysms via a unilateral approach is possible without additional surgical morbidity.
