Journal of Korean Society of Geriatric Neurosurgery 2010;6(2):81-87.
Published online October 30, 2010.
Outcome of Patients with Aneurysmal Subarachnoid Hemorrhage Aged 80 Years or Older
Hyun Yong Choi1 , Yong Cheol Lim1 , Jae Gyu Kang1 , Yong Sam Shin2
1Departments of Neurosurgery, School of Medicine, Ajou University, Suwon, Korea 2Departments of Neurosurgery, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
80세 이상의 동맥류 파열에 의한 지주막하 출혈 환자의 치료 결과 고찰
최현용1ㆍ임용철1ㆍ강재규1ㆍ신용삼2
아주대학교 의과대학 신경외과학교실1, 가톨릭대학교 성모병원 신경외과학교실2
Abstract
Objective
In recent years, elderly population is rapidly increasing, approximately 1.8% of the Korean population has reached 80 years of age. Since the prognosis for intracranial aneurysm patients 80 years of age and older remain unclear and is thought to be worse than that of patients under 80 years of age because of the higher frequency of complications.
Methods
We retrospectively reviewed the medical records of intracranial aneurysmal subarachnoid hemorrhage (SAH) patients aged 80 years or older, who were treated in a single center between January 2001 and December 2009.
Results
A total of 1,517 patients with intracranial aneurysm were treated during the study period. There were 27 patients (80-89 year old and 88.9% female), representing 1.8% of all intracranial aneurysms. All of these patients had aneurysmal SAH. Of those, 24 patients (88.9%) received a coil embolization and the remaining 3 patients were managed by microsurgical clipping. The number of good clinical outcomes (defined as a Glasgow Outcome Scale of 1-3) 3 months after the SAH was fourteen (51.9%). Ten patients (37.0%) died within 3 months. Among the deaths, four patients died secondary to the SAH, remaining six patients died of pneumonia.
Conclusion
Because of recent advances in endovascular coiling techniques and less invasive intervention than microsurgical clipping, elderly patients are more likely to receive coil embolization and have a better opportunity for a good clinical outcome. Medical complication, especially pneumonia was associated with a mortality and poor outcome. In elderly SAH patients, careful medical treatment should be considered more actively.
Key Words: ElderlyㆍSubarachnoid hemorrhageㆍEndovascularㆍCoil embolizationㆍPneumonia


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