Treatment of intracranial aneurysms associated with other entities.

Considering the current state of surgery for intracranial aneurysm, a philosophy for treating intracranial aneurysms associated with other entities is presented. The premise is based on a comprehensive review of the literature relative to the risk factors applied to intracranial aneurysms and personal experience in dealing with the combination of problems of aneurysms diagnosed in association with other intracranial aneurysms, vascular malformations, neoplasms, trauma, and inflammatory diseases. A patient's problem must be considered individually and comprehensively, using all known prognostic factors and the specific features of the case for an appropriate therapeutic regimen to be designed. Current mortality and morbidity rates warrant the surgical intervention for the incidentally diagnosed aneurysm, but the occurrence of an aneurysm in conjunction with another serious entity demands careful, comprehensive evaluation. The surgical challenge of these complex problems should take second priority to a careful therapeutic deliberation to promote the best final outcome.