Just had a clipping on 3 aneurysms. Needless to say I had an 18 (yes...really..not lying. Largest one the neurosurgeon from Mayo had ever seen), a 7 on the 18 (yep, an aneurysm on an aneurysm...see the 18 could get worse), and a 14 behind my ear in the temporal lobe.

So I had a bad case of the aneurysms (lol). Tho the sizes sound terrible, but since they seemed stable other than the fact that I had lost sight and use of my right eye, I had a choice of clip or coil. I chose clipping. I chose it partly because I was worried about that second one. I was worried about how unstable an aneurysm on an aneurysm could be. But mostly, because I didn't want to live with the fear of the coil collapsing over time and it rupturing in two of the worse areas you can have one, let alone 3. In the end I chose right. But only because of an unforseeable occurrence. The 3rd one ruptured just as they started the right side craniotomy.

So in a list, things to think about:
1. Size and progression and stability
2. Your personal feelings of comfort for future.
3. Invasiveness - If a craniotomy is warranted it is serious surgery. Recovery is tough and draining. Time away from work, rehab, and to be honest pain. Tho not as must pain as you would expect. And there will be scars and possible hair shaving, etc. Depending upon where they are, the scars could be visible to some extent. Also, tho a good neurosurgeon can now eliminate alot of the visible incisions with current methods. There are other less invasive procedures they can use to do the clipping but only if the aneurysm is in an area that would permit, and is close to the surface.
4. Other possible scenarios that would impact long-term outcome (ie. my 2nd one that was like a bubble on a balloon...seemed very unsafe to me)

Hoped this help. Also really hope didn't say anything to bother you. I had an extreme case and I want you to take heart from that. I have had great results. But if the answer to questions #1 above for me had been 6-7's and stable, I very likely would have chosen the other option. Things have turned out better than the docs could have conceived for me, but it was not easy and I still have months to go. I would definitely take it ten times over rather than not be here to tell my story.