AIM: This work aims to summarize the experience in emergency microsurgery for patients with aneurysmal subarachnoid hemorrhage (SAH) that coexisted with brain hernia.

MATERIAL and METHODS: A total of 26 patients with aneurysmal SAH complicated by brain hernia were subjected to emergency aneurysm clamping + decompressive craniectomy. 10 patients were diagnosed with aneurysmal SAH coexisted with brain hernia before operation.

RESULTS: Four patients had a carotid aneurysm, 15 had a middle artery aneurysm, and 7 had an anterior communicating aneurysm. The surgical procedure was performed smoothly for all patients. The patients were followed up for 3 months to 6 months. According to Glasgow outcome scaling, five patients recovered well, six suffered from moderate disability, five were subjected to severe disability, five were in plant survival, and 5 died.

CONCLUSION: Emergency surgical exploration is an effective treatment method for patients