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KMID : 1150320160120020198
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Journal of Korean Society of Geriatric Neurosurgery
2016 Volume.12 No. 2 p.198 ~ p.205
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Surgical and Endovascular Treatment for Cerebral Aneurysms in Elderly Patients: Clinical Course, Complications and Outcomes
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Lee Kyoung-Hee
Park In-Sung
Yoo Chai-Min
Lee Kwang-Ho
Lee Chul-Hee
Han Jong-Woo
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Abstract
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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.
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KEYWORD
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Aneurysm, Subarachnoid hemorrhage, Medical complication, Glasgow outcome scale
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