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

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  • TADA Yoshiteru
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • SATOMI Junichiro
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • YAGI Kenji
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • MATSUSHITA Nobuhisa
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • YAMAMOTO Nobuaki
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • KANEMATSU Yasuhisa
    Department of Neurosurgery, School of Medicine, The University of Tokushima
  • NAGAHIRO Shinji
    Department of Neurosurgery, School of Medicine, The University of Tokushima

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  • 80歳以上の破裂脳動脈瘤の治療成績

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Abstract

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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