J Cerebrovasc Endovasc Neurosurg.  2014 Sep;16(3):193-199. 10.7461/jcen.2014.16.3.193.

Clinical Outcomes of Treatment for Intracranial Aneurysm in Elderly Patients

Affiliations
  • 1Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea. nsyclim@gmail.com

Abstract


OBJECTIVE
The aim of this study is to evaluate the clinical course of intracranial aneurysm in patients aged 65 years and older and the immediate outcome after its aggressive management.
MATERIALS AND METHODS
We performed a retrospective analysis using the medical records of 159 elderly patients managed at our institute from September 2008 to December 2013. Obtained clinical information included age, sex, Hunt and Hess grade (HHG), aneurysm location, Fisher grade (FG) and the treatment modality. Concomitant clinical data aside from cerebrovascular condition (hypertension, diabetes, previous medication) were evaluated to determine risk factors that might affect the functional outcomes.
RESULTS
A total of 108 patients (67.9%) presented with subarachnoid hemorrhage (SAH), and 51 (32.1%) with unruptured intracranial aneurysms (UIAs). Coiling was performed in 101 patients and 58 patients underwent clipping. In the SAH population, 62 patients (57.4%) showed favorable outcomes, with a mortality rate of 11.3% (n = 18). In the UIAs population, 50 (98%) patients achieved 'excellent' and one (2%) achieved 'good' outcome. Factors including high-grade HHG (p < 0.001), advanced age (p = 0.014), and the presence of intraventricular hematoma (IVH) (p = 0.017) were significant predictors of poor outcome.
CONCLUSION
SAH patients with high grade HHG and IVH are associated with poor outcome with statistical significance, all the more prominent the older the patient is. Therefore, the indication for aggressive therapy should be considered more carefully in these patients. However, as the outcomes for elderly patients with UIAs were excellent regardless of the treatment modality, aggressive treatment could always be considered in UIAs cases.

Keyword

Elderly; Intracranial aneurysm; Subarachnoid hemorrhage; Outcome; Microsurgical clipping; Endovascular coiling

MeSH Terms

Aged*
Aneurysm
Hematoma
Humans
Intracranial Aneurysm*
Medical Records
Mortality
Retrospective Studies
Risk Factors
Subarachnoid Hemorrhage

Figure

  • Fig. 1 Clinical outcome of all patients with intracranial aneurysm according to treatment modality (A) and patients with subarachnoid hemorrhage (B).


Cited by  1 articles

Clinical Outcomes of Large (>10 mm) Unruptured Posterior Circulation Aneurysms and Their Predictors
Joonho Byun, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn
J Korean Neurosurg Soc. 2021;64(1):39-50.    doi: 10.3340/jkns.2020.0028.


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