80歳以上の破裂脳動脈瘤の治療成績

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  • Treatment Outcomes in Patients Older than 80 Years Presenting with Ruptured Intracranial Aneurysms

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While the number of elderly patients who presented with aneurysmal subarachnoid hemorrhage (SAH) has been increasing, its optimal management in that population remains controversial. Therefore, we retrospectively reviewed the treatment outcomes in 49 consecutive patients aged between 80 and 94 years who presented with SAH. <br> The neurological World Federation of Neurological Surgeons (WFNS) grade at the time of admission was Grade I in 7, Grade II in 11, Grade III in 8, Grade IV in 13, and Grade V in 10 patients. Of the 49 patients, 28 underwent coil embolization, and 7 (25%) had a favorable outcome (mRS: 0–2) at discharge, while in 21 (75%) the outcome was poor (mRS: 3–6). Six patients underwent clipping; the outcome was favorable in one patient (17%) and poor in 5 (83%). Of 15 patients under conservative therapy none had a favorable outcome. A low WFNS grade (I–II) was significantly associated with a favorable outcome (p＜0.05). <br> Although the treatment outcome in elderly patients with SAH was poor, radical treatment of ruptured aneurysms should be considered if their WFNS grade is low. <br>

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  • 脳卒中の外科

    脳卒中の外科 42 (1), 42-46, 2014

    一般社団法人 日本脳卒中の外科学会

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