Clinical Characteristics and Surgical Results of Aged Patients with Ruptured Intracranial Aneurysms Operated on in an Acute Stage

概要

論文の詳細を見る
We analyzed clinical characteristics and surgical results in 44 patients aged 70 years or more with ruptured intracranial aneurysms operated on within 72 hours of hemorrhage. In comparison with a non-aged group of 264 patients aged less than 70 years (126 men and 138 women), the aged group (6 men and 36 women) showed a distinct female preponderance. The most common parent artery of ruptured aneurysm was the internal carotid artery in the aged group, while it was the anterior cerebral artery in the non-aged group. There. was no significant difference in the preoperative clinical grades (Hunt & Kosnik classification) between the two groups.<BR>Although delayed ischemic neurological deficit (DIND) appeared in both groups at almost the same frequencies, 32% and 34% for the aged and non-aged group, respectively, the incidence of permanent DIND was higher in the aged group (50%) than in the non-aged group (36%). The comparative studies on surgical results in each clinical grade revealed that outcomes of Grade IV patients were extremely poorer in the aged group (92% poor outcome) than those in the non-aged group (58% poor outcome, <I>p</I>=0.02). Although Grade III patients in the aged group also showed poorer outcomes, it did not reach statistical significance. Overall outcomes in a subgroup of patients aged 70-74 were almost the same as those in the non-aged group. Thus indications for early aneurysm surgery in aged patients, when their ages are under 75 and clinical grades below G III, are determined with the same standards as in non-aged patients. Among the factors accounting for poor outcome of each patient, the incidence of primary brain damage was higher in the aged group (53%) than that in the non-aged group (43%). These results indicate that the major cause of poor outcomes of aged patients is a poor recovery from brain damage due to either primary hemorrhage or symptomatic vasospasm.
The Japanese Society on Surgery for Cerebral Strokeの論文

Clinical Characteristics and Surgical Results of Aged Patients with Ruptured Intracranial Aneurysms Operated on in an Acute Stage

スポンサーリンク

概要

著者

関連論文

スポンサーリンク