Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):81-86.
Published online December 30, 2014.
The Treatment Result of Ruptured Aneurysm in Geriatric Patients: Comparative Analysis of Between 65-74 and Older than 75
Ui Seung Hwang , Seung Hwan Lee , Hee Sup Shin , Jun Seok Koh
Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
노인 환자에서 파열성 뇌동맥류의 치료 결과에 대한 연구: 65-74세와 75세 이상 두 그룹 간의 비교 연구
경희대학교 의과대학 신경외과학교실
As medical services evolve, the average life span of individuals has increased, with most people now surviving until their early 80’s. Thus, the geriatric population older than 75 years old is growing considerably. We compared aneurysm characteristics, treatment methods, and clinical outcomes in a group of patients aged 65 to 74 years with a ruptured aneurysm(group A) with those of a group older than 75 years (group B).
Over a 4-year period, 603 aneurysms in 461 patients were treated with surgical clipping and/or endovascular coiling. Sixty-five (14.1%) patients were classified as group A, and 20 (4.3%) were classified as group B. There were 12 males and 53 females (1:4.4) in group A and 5 males and 15 females in group B (1:3). The locations and treatment methods of the aneurysms and the GOS were retrospectively reviewed.
The aneurysms were located in the anterior cerebral artery (ACA) of 20 patients, the middle cerebral artery (MCA) of 16 patients, the internal carotid artery (ICA) of 15 patients, and the posterior circulation of 14 patients in group A. In group B, 8 aneurysms were located in the ACA, 9 were in the ICA, 1 was in the MCA, and 2 were in the posterior circulation. In group A, the aneurysms were treated with clipping in 40 patients and coiling in 25 patients. In group B, clipping was used in 12 clipping, and coiling was performed in 8 patients. The mean maximum size of the aneurysms was 5.86mm in group A and 6.10mm in group B. A total of 55.4% of the patients in group A and 25.0% in group B had a good clinical outcome (p<0.05).
There were no significant between-group differences in the characteristics of the aneurysms or the treatment
. However, there were significant between-group differences in clinical outcomes. Careful treatment of ruptured aneurysms is mandatory in patients older than 75 years.
Key Words: AneurysmㆍElderly patientsㆍGeriatric patientsㆍSubarachnoid hemorrhage

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