Surgical and Endovascular Treatment for Cerebral Aneurysms in Elderly Patients: Clinical Course, Complications and Outcomes |
Kyoung Hee Lee1 , In Sung Park1,2 , Chai‐Min Yoo1 , Kwang Ho Lee1 , Chul‐Hee Lee1 , Jong Woo Han1 |
1Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, 2Gyeongsang Institute of Health Science, Jinju, Korea |
70세 이상의 노인 환자에서 뇌동맥류의 개두술 및 혈관내 색전술에 대한 치료: 임상 경과, 합병증 및 예후 |
이경희1·박인성1,2·유채민1·이광호1·이철희1·한종우1 |
경상대학교 의과대학 신경외과학교실1, 경상대학교 건강과학연구원2 |
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Abstract |
Objective The number of elderly people and patients increasing admission rate with aneurysmal subarachnoid hemorrhage in Korea. Treatment of aneurysm in elderly people has to be controversial. We have investigated the epidemiology and management outcome of cerebral aneurysms in elderly patients.
Methods We retrospectively analyzed the prevalence and surgical outcomes of unruptured and ruptured cerebral aneurysms in the elderly. A total of 318 patients were enrolled in Gyeongsang National University Hospital of cerebral aneurysm between 1995-2015, 258 with ruptured cerebral aneurysms and 60 with unruptured cerebral aneurysms were patients aged ≥70 years.
Results The data of 318 patients were retrieved, 258 patients experienced subarachnoid hemorrhage. They had 411 aneurysms, the average aneurysm size was 6.64mm. Neurosurgical clipping was carried out in 170 patients, 147 patients treated by coil embolization. We used Glasgow outcome scale at the time of discharge, 37 patients were in GOS I, 28 were in GOSII, 66 were in GOS III、60 were in GOS IV, 127 were in GOS V. In-hospital death was 37 patients (GOS I), cause of death include initial hemorrhage (n=4), recurrent hemorrhage (n=7), secondary ischemia (n=11) and medical complications (n=15).
Conclusion This report provides an analysis of outcomes following the surgical treatment on elderly patients who have cerebral aneurysms. The common reason for poor outcome is medical complications. Treatment of the aneurysm in elderly patients is feasible, may improve the outcome and should be strongly considered in a good condition. |
Key Words:
Aneurysm, Subarachnoid hemorrhage, Medical complication, Glasgow outcome scale |
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