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KMID : 1005420100120030190
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Journal of Cerebrovascular and Endovascular Neurosurgery
2010 Volume.12 No. 3 p.190 ~ p.195
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Treatment outcome of ruptured cerebral aneurysms in the elderly
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Yoon Ki-Sung
Choi Chan-Young
Han Seong-Rok
Lee Gi-Taek
Son Moon-Jun
Lee Chae-Heuck
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Abstract
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Objective : This study aimed to assess the results of surgical and endovascular treatments in aneurysmal subarachnoid hemorrhage (SAH) patients older than 70 years.
Methods : This study included 18 patients, more than 70 years of age, treated for ruptured cerebral aneurysms between April 2004 and March 2009. In most cases, patients underwent the early obliteration procedure for each aneurysm, and we compared the clinical results according to the obliteration method (clipping or coiling). We assessed neurological outcomes at 6 months post-procedure according to the modified Rankin Scale (mRS): favorable (mRS score > 2) or unfavorable (mRS score > 2).
Results : Of the 18 patients, 12 (66.6%) underwent obliteration of the aneurysm sac via microvascular clipping patients, and 6 (33.3%) underwent endovascular coiling. At 6 months post-procedure, the clinical outcomes were favorable in 6 patients (33.3%), 5 (41.7%) who received microvascular clipping and 1 (16.7%) who underwent endovascular coiling. Unfavorable outcome was not statistically associated with poor initial clinical state, poor Fisher grade, occurrence of stroke, or hydrocephalus, although we frequently noted these variables in the unfavorable outcomes.
Conclusions : In this study, aneurysm obliteration method (microvascular clipping vs. endovascular coiling) did not seem to significantly affect clinical outcomes. A poor initial clinical state, poor Fisher grade, occurrence of stroke, and hydrocephalus seemed to be associated with poor clinical outcomes.
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KEYWORD
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cerebral aneurysm, subarachnoid hemorrhage, surgical clipping, endovascular coiling, elderly
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