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Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation
Subarachnoid hemorrhage with anterior communicating artery (Acomm) aneurysm not repairable using endovascular techniques
Aneurysm presenting with symptoms referable to mass effect
Unruptured aneurysm (≥ 7 mm) in a patient 50 years old or younger
Aneurysm with intraluminal thrombus
Anterior projecting aneurysm
Hunt and Hess grade I, II, or III in a patient 50 years old or younger
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