**8. Conclusion**

Our understanding of blister aneurysms is still today incomplete. Having a relatively wide spectrum of pathological differentiations, they can be classified as either true or false lesions. Whether this represents consecutive stages of the same entity or a different, in each case, disease remains to be clarified. Further research on the field is an absolute necessity, and young physicians should thus be encouraged toward this direction by their senior colleagues.

A direct consequence of our limited knowledge on the nature of blister aneurysms is the lack of an established and universally accepted treatment modality. This lack of consensus has led to numerous attempts at novel and often promising therapies. However, and with the sole exception of the recently introduced flow diverters, all previous options have invariably failed to rise to initial expectations.

Flow diversion, despite its limitations, arises today as probably the most attractive future prospect. However, until our technology reaches that point, blister aneurysms are still to be treated on a case-by-case basis. In this context, when confronted with such a lesion, physicians should consider all available alternatives, both surgical and endovascular, in order to maximize the chances of a good outcome.

Whichever end treatment modality is to be used, an important point when dealing with a patient that has suffered rupture of a blister aneurysm is amelioration of perihemorrhage management in its entity. Careful consideration of all measures to prevent and, if needed, manage rebleeding or any other related complications (i.e. vasospasm, hydrocephalus, seizures) is essential. All these issues would preferably be addressed within a multidisciplinary team consisting of neurosurgeons, interventionists and ICU specialists should the best possible result be achieved.

As with every other such case, and despite initial enthusiasm, each new therapeutic approach proposed for blister lesions needs careful consideration and long periods of follow-up to evaluate its efficacy, safety and durability of results. It is obvious that further research in the field is an absolute necessity and young physicians should be encouraged toward this direction.
