Objective      To investigate the diagnosis and treatment of distal anterior cerebral artery aneurysms (DACAA).       Methods      Clinical data of 32 DACAA patients admitted in our hospital from January 2007 to December 2012 were collected and retrospectively analyzed. All the cases were diagnosed on a basis of computed tomography angiography (CTA) or digital subtraction angiography (DSA). There were a total of 36 DACAA

including 4 cases of multiple aneurysms. According to the results of Hunt-Hess grade

the condition of cerebral vasospasm and the anatomical features of DACAA

the cohort were divided into microsurgical clipping group and intervention treatment group. Twenty-two cases underwent microsurgical treatment

including 2 cases failed in endovascular treatment. The necks of 25 aneurysms were clipped and only one was excised. There were 10 cases underwent embolization treatment.       Results      There were 23 aneurysms completely occluded and 2 aneurysms incompletely occluded. The parent artery of 1 case was occluded in the microsurgical group. There were 6 cases of dense embolism in the endovascular embolization group

1 case of tumor embolism

and 3 cases of parent artery occlusion.       Conclusion      Both intervention and surgical clipping have their pros and cons. The former is suitable for Hunt-Hess grade Ⅲ to Ⅳ

mild cerebral vasospasm and narrow neck of aneurysm

while

the latter is suitable for Hunt-Hess gradeⅠ to Ⅱ

severe cerebral vasospasm and aneurysm with intracranial hematoma. Since the latter approach is prone to cause to clip or incomplete embolization

especially for the embolization treatment

we are inclined to microsurgery surgery.