Objective    To summarize the experience and effectiveness of early surgical treatment of middle cerebral artery (MCA) aneurysms associated with intracerebral haematoma.     Methods    Nine patients with ruptured MCA aneurysms associated with intracerebral haematoma

who underwent haematoma evacuation and aneurysmal clipping

were retrospectively reviewed. Preoperative conventional angiography or/and three-dimensional CT angiography (3D-CTA) was performed in seven patients. Another two patients underwent urgent surgery after CT scanning. Intraoperative Doppler sonography was used to assist exposure of aneurysms and parent vessels before and after aneurysm clipping.     Results    Ten aneurysms in nine patients were clipped. GOS at three months was good recovery in four cases

moderate disability in two

severe disability in two

and persistant vegetative state in one.     Conclusion    Acceptable outcome may be achieved in the patients with ruptured MCA aneurysms associated with intracerebral haematoma after early surgery. 3D-CTA and intraoperative Doppler sonography are helpful for surgical treatment.