Management of Elderly Patients with Incidentally Discovered Unruptured Aneurysms |
Byoung Hun Lee , Yong Sook Park , Jeong Taik Kwon , Young Baeg Kim |
Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea |
고령에서 우연히 발견된 비파열성 뇌동맥류의 치료 |
이병훈ㆍ박용숙ㆍ권정택ㆍ김영백 |
중앙대학교 의과대학 신경외과학교실 |
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Abstract |
Objective Indications for surgical treatment of unruptured aneurysms are generally thought to depend on age, physical and neurological status, concomitant disease, and location, size, and shape of aneurysms. Increased surgical risks and reduced life expectancy among the elderly would decrease the surgical benefits, and even minor perioperative complications may cause serious problems.
Methods We retrospectively analyzed the management outcomes of unruptured cerebral aneurysms in the elderly. The age of patients was based on more than 60 years. Aneurysm location, size and management related complications were investigated. Management was performed as a microsurgical clipping or coil embolization.
Results From March 2005 to March 2010, 61 patients were enrolled; 31 patients were treated with surgical clipping and 30 patients with coil embolization. The mean size of aneurysm was 6.0x4.5 mm in clipped group and 4.7x3.8 mm in coiled group. The mean size of aneurysm neck was 3.3 mm in clipped group and 2.9 mm in coiled group. Complicated aneurysms were more frequently distributed in clipped group (10/31) rather than coiled group (0/30). Eight of 31 patients showed postoperative neurologic deficits in clipped group whereas no patients were deteriorated in coiled group.
Conclusion With increasing proportion of aged people, the detection rate of unruptured cerebral aneurysms in the elderly has also been rising. Management of unruptured aneurysms in elderly patients will be much more important in the coming years. Further prospective studies to accumulate data related both to the natural history of unruptured aneurysms and to surgical outcomes are necessary to determine surgical indications for unruptured aneurysms in the elderly. |
Key Words:
Unruptured cerebral aneurysmㆍSurgical treatmentㆍOutcomeㆍElderly |
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