Objectives: To evaluate difficultiesin microsurgical treatment for anterior communicating artery (ACoA) aneurysms. Methods: This prospective study included 44 patients admitted Bach Mai and Viet-Duc hospital for ruptured ACoA aneurysms, between 1/2013 and 2/2014. Results: Female/Male: 1/1.1; Mean age 45.7. 54,5 percent patients were in clinical grade 1-2. During operation, rate of intraoperative rupture were 20.4 percent, cerebral swelling were 43.2 percent. Aneurysmal morphology: large neck 31.8 percent. multiple aneurysms of ACoA 9.1 percent, superiorly or inferiorly tilted 52.3 percent, 6.8 percent giant aneurysms, contralateral A1 hypoplasia (43.2 percent)/aplasia (15.9 percent), postoperative complication 15.9 percent, 79.5 percent good clinical outcome, 11.4 percent bad outcome. Conclusions: Microsurgery can be effective in treatment of ruptured ACoA aneurysms. The main intraoperative difficulties include brain swelling, rupture, anatomic anomalies of aneurysms.
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