Clinical Analysis of Operation for Elderly Patients with Cerebral Aneurysmal Subarachnoid Hemorrhage

ABSTRACT

OBJECTIVE: The number of elderly patients with cerebral aneurysm has markedly increased. We investigate the clinical characteristics and the surgical outcomes of cerebral aneurysms of elderly patients aged over 65 years comparing with those of control group aged under 65 years. METHODS: Total 439 patients were done aneurysm surgery between January 1998 to December 2002. The clinical data of 78 old-aged patients and 361 control group patients were reviewed to assess the relationship between sex, Hunt-Hess grade at admission, Fisher's grade at admission, site of aneurysm, timing of surgery, vasospasm, hydrocephalus, surgical outcome and age. RESULTS: The proportion of female, poor Hunt-Hess grade, poor Fisher's grade and hydrocephalus were significantly higher in old-aged patients than those of control group. But aneurysmal site and the rate of vasospasm were not different significantly in these two groups. Favorable outcomes were 75.6% for control group patients and 67.9% for old-aged patients. The surgical outcome was not statistic significantly different between two groups. The main causes of unfavorable outcome among elderly patients were attributed to their poorer Hunt-Hess grades on admission and postoperative medical complications. CONCLUSION: We conclude that old age is not a contra-indication for aneurysm surgery for elderly patients. And also after surgery, aggressive treatment and prevention of medical complications can lead to a better outcome.