高齢者破裂脳動脈瘤症例における脳血管攣縮

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The outcome of cerebral vasospasm in aged patients with ruptured intracranial aneurysms was compared with that in younger patients. Patients with brain damage due to previous stroke intracerebral hematoma, or surgical complications were excluded from the study. The study population consisted of 143 patients hospitalized between 1982 and 1986. Neck clipping of ruptured aneurysms and continuous ventricular drainage were carried out within 3 days after onset. At 3 months after subarachnoid hemorrhage the incidence of poor clinical results was significantly higher in patients over 64 years of age than in younger patients (p<0.005). Therefore, in this study "aged" was defined as 65 years of age or older. There were 25 patients in the aged group (eight males and 17 females; mean age, 68±3 years). The younger group comprised 118 patients (62 males and 56 females; mean age, 52±8 years). The clinical manifestations of cerebral vasospasm were evaluated 3 months after subarachnoid hemorrhage and classified as either transient or permanent. Between the aged and younger groups there were no difrerences in the extent of subarachnoid hemorrhage, the incidence of vasospasm as demonstrated by angiography, or the incidence of symptomatic vasospasm. However, the incidence of permanently symptomatic vasospasm was significantly higher in the aged group (81.8% of all patients with symptomatic vasospasm) than in the younger group (30.2%) (p<0.01). Systemic complications appeared to have a greater effect on symptoms of vasospasm in the aged than in the younger patients.
日本脳神経外科学会の論文
1988-08-15

高齢者破裂脳動脈瘤症例における脳血管攣縮

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