| Microsurgical Treatment of Ruptured Intracranial Aneurysms in Geriatric Subarachnoid Hemorrhage Patients |
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Woo-Keun Kong , Byeong-Chul Kim , Keun-Tae Cho , Seung-Koan Hong |
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Department of Neurosurgery, Dongguk University Ilsan Hospital, Goyang, Korea |
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| Abstract |
Objective
This clinical analysis was performed to assess the clinical characteristics and postoperative outcomes of geriatric patients aged over 60 years treated with microsurgical neck clipping of ruptured intracranial aneurysms.
Methods
Retrospective analysis was carried out in 39 patients aged over 60 years in whom microsurgical neck clipping for subarachnoid hemorrhage due to ruptured aneurysms was performed. The clinical data of the patients were analyzed according to age, gender, underlying diseases, location and size of the aneurysms, aspect of subarachnoid hemorrhage, initial neurological status, complications, and postoperative outcomes. Postoperative outcomes were analyzed by Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) at 3 months following surgical treatment.
Results
Postoperative outcomes at 3 months were excellent (mRS 0-1) in 12 (30.8%) patients, good (mRS 2-3) in 13 (33.3%) patients, poor (mRS 4-5) in 11 (28.2%) patients, and 3 (7.7%) patients expired (mRS 6). Outcomes in regard with Hunt-Hess Classification according to mRS scores presented good to excellent results (mRS 0-3) in 10 (100%) patients between Hunt-Hess Classification grade between 1-2, 10 (71.4%) patients with Hunt-Hess Classification grade of 3, and 5 (33.3%) patients with Hunt-Hess Classification grade between 4-5. Considerable proportion of patients included in this study presented favorable postoperative outcomes.
Conclusion
Geriatric age should not be considered as a factor for avoiding microsurgical treatment of ruptured intracranial aneurysms. Surgical neck clipping of ruptured intracranial aneurysms in geriatric subarachnoid hemorrhage patients can considerably lead to good postoperative outcomes. Furthermore, improvements in outcomes can be optimized by intensive postoperative managements to prevent complications. |
| Key Words:
Subarachnoid hemorrhageㆍIntracranial aneurysmㆍSurgical clippingㆍOutcomeㆍElderly |
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