OBJECTIVE: To summarize individualized surgical treatment strategies for @entity438 . METHODS: Twenty @entity1 with @entity438 treated by microsurgery in Chinese @entity1 's Liberation Army General Hospital between December 2009 and November 2012 were retrospectively analyzed. There were 12 male and 8 female @entity1 , with a mean age of 43 years (range: 14-58 years). @entity439 (size > 2.5 cm) were found in 6 cases, @entity439 in 7 cases and @entity9155 ones in 3 @entity1 . Important perforators were involved in @entity439 neck in 2 cases. Important branches originated from @entity439 in 6 @entity1 . Two @entity1 harbored recurrent @entity439 after coiling. Individualized surgical strategies were planned according to preoperative imaging. A frontotemporal approach was routinely used. Intraoperative somatosensory evoked potential monitoring, indocyanine green videoangiography and microvascular Doppler ultrasonography were regularly used. A postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA) was performed to verify the efficacy of treatment and patency of bypass vessels. RESULTS: Of the 20 cases, 7 @entity439 were clipped with clipping and reconstruction of parent artery with multiple clips, 3 M1 segment @entity439 were proximally occluded with extra-intracranial high-flow revascularization, 2 @entity439 were treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization, 1 @entity439 was treated with aneurysmectomy with superficial temporal artery to middle cerebral artery low-flow revascularization and branch side-to-side @entity254 , 2 @entity439 were treated with aneurysmectomy and re- @entity254 of parent artery, 1 @entity439 was treated with aneurysmectomy and @entity21962 , 3 bilateral MCA @entity439 were clipped by unilateral approach, and 1 was trapped. Nineteen @entity1 were favorable with Glasgow Outcome Scale score 4-5 at discharge, and 1 @entity1 died of @entity1188 one week after surgery. The mean clinical follow-up was 20 months (range: 6-39 months). During follow-up, no @entity548 occurred. DSA or CTA confirmed absence of @entity439 in 14 cases and residual neck in 2 @entity1 . The other 3 @entity1 were lost to follow-up. CONCLUSIONS: Individualized, multi-modality surgical treatment strategies are effective and safe solution for treatment of @entity438 . Revascularization remains imperative surgical technique.

[Individualized surgical treatment of XXXX ].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'People'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'Giant aneurysms', 'wide-neck aneurysms', 'aneurysm'] @entity21962 :: ('MESH:D020144', 'Disease') :: ['re-anastomosis of parent artery and reinplantation of lenticulostriate artery'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['cardiac infarction'] @entity9155 :: ('CHEBI:46670', 'Chemical') :: ['serpentine'] @entity438 :: ('MESH:D002532', 'Disease') :: ['complex MCA aneurysms', 'complex middle cerebral artery (MCA) aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['complex middle cerebral artery aneurysms']
