目的　比较显微外科与血管内治疗对多发性颅内动脉瘤 (MIA)的治疗效果和并发症发生率的差别。　方法　回顾分析 2 0例MIA(共 46个动脉瘤 ) ,根据MIA所在部位的区域分级标准 ,Ⅰ级 8例 (占 40 % ) ,Ⅱ级 10例 (占 5 0 % ) ,Ⅲ级 2 (占 10 % )。级别越高者 ,多倾向于选择血管内治疗。　结果　显微外科手术组 8例 ,共 19个动脉瘤 ,18个镜下全部夹闭、1个没发现未夹闭。血管内治疗组8例 ,共 17个动脉瘤 ,14个 10 0 %闭塞、1个 90 %以上闭塞、2个因动脉瘤小导管不能到位未治。颅内外血管搭桥加颈内动脉闭塞 2例。未治 2例。　结论　MIA所在部位的区域分级有助于治疗方法的选择 ,对MIA多倾向于血管内治疗 ,必要时可 2种方法联合应用。 Objectives To compare the difference in the treatment effect and complication rate of multiple intracranial aneurysms (MIA) between microsurgery and endovascular treatment. METHODS: Twenty patients with MIA (a total of 46 aneurysms) were retrospectively analyzed. According to the regional grading criteria of the MIA site, 8 patients (40%) were in grade I, 10 patients (50%) were in grade II, and 2 were accounted for in grade III. 10%). The higher the level, the more inclined to choose endovascular treatment. Results In the microsurgery group, there were 8 cases with 19 aneurysms, 18 were all under the microscope and 1 was not found without clipping. In the endovascular treatment group, there were 8 aneurysms, 17 aneurysms, 14 10% occlusion, 1 occlusion more than 90%, and 2 aneurysm small ducts that could not be left untreated. Intracranial and extracranial bypass and internal carotid artery occlusion were performed in 2 patients. Two were left untreated. Conclusion The regional classification of the site of MIA is helpful to the choice of treatment methods. MIA tends to be treated with endovascular therapy more often. If necessary, two methods can be combined.