A subarachnoid hemorrhage is bleeding into the subarachnoid space that is the area between the arachnoid membrane and the piamater. SAH is a common disease with high morbidity and mortality. The cause of non-traumatic SAH is a rupture of a real cerebral aneurysm in 85% of cases. The aneurysms tend to be located in the branch of circle of Willis. Key points about aneurysmal subarachnoid hemorrhage: A. The average incidence of subarachnoid hemorrhage is 6 per 100,000 annually. B. The group of people at risk...

We retrospectively reviewed 23 patients with very small intracranial aneurysms associated with HSA and treated by endovascular method in our centre, to January 2008 until January 2011. We analyzed the epidemiological characteristics, clinical degree (Hunt and Hess scale), size and location, time to treatment, type of endovascular treatment, complications associated with the procedure, anatomic results (Montreal scale), rebleeding, mortality, prognosis after 12 months (mRS scale) and recanalization.

Patient Characteristics: A total of 23 patients were included (12 female and 11 male). Hunt and Hess grade was I in 3 cases (75.0%),II in 14 cases (12.5%), III in 1 cases (8.3%), and IV - V in 5 patient (4.2%). Aneurysm Locations: Anterior circulation 20/23 (83%) Anterior Communicating artery 14/20 (70%) Carotid Artery 2/20 Bifurcation MCA 1/20 Coroidea. 3/20 Posterior Circulation: 3/23 (13%) Posterior inferior cerebellar 3/3 Assisted techniques: Nineteen (83%) were treated with assistance of assisted techniques: remodeling balloon. Anatomic results, Montreal scale:...

Historically the treatment of very small rupture aneurysms is surgical because the endovascular treatment implies great technical difficulties but with new technical advances is possible. Endovascular treatment is associated with a greater number of technical complications but with a similar clinical prognosis respect to larger aneurysms. Appropriate management of complications is essential to achieve good clinical outcomes. The use of balloon remodeling is essential to obtain these results. Therefore endovascular treatment of very small aneurysms is effective and should be considered similar to larger aneurysms.

1.Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 2005;366:809-817 2.Brinjikji W, Lanzino G, Cloft HJ, Rabinstein A, Kallmes DF. Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: report of a consecutive series and a meta-analysis. Stroke 2010;41:116-121 3.Gallas S, Pasco A, Cottier JP,...