Abstract: Objective To explore the diagnosis and treatment strategy of multiple intracranial aneurysms (MIA). Methods We
retrospectively analyzed 96 patients with MIA (234 aneurysms). The rupture site was determined on the basis of computed
tomographic and angiographic findings, and the supposed ruptured aneurysm was treated with coiling OR clipping. All the
patients’ records were reviewed including all computed tomographic scans and angiograms. Results Twelve patients received
conservative treatment, 56 patients were treated by endovascular embolization, and 28 patients received clipping; 44 patients
received one-stage treatment, and 4 patients needed a second therapy. In 36 patients, only the ruptured aneurysm was
eliminated. The clinical outcomes of these 84 patients evaluated by Glasgow Outcome Scale grades were: absence of deficits in
62 patients, minor deficits in 12 patients, major deficit in 8 patients; death occurred in 2 cases. Thirty patients were available for
a 6-month follow-up with DSA, which revealed stable occlusion of the aneurysms in 29 patients and the need of a retreatment
due to recanalization in only one patient. Conclusion Correct localization of the rupture aneurysm based on a comprehensive
diagnosis is key to MIA treatment. All the aneurysms should be treated in one session whenever possible to protect the patient
from rebleeding.