| Clinical Analysis of Multiple Intracranial Aneurysms in the Elderly Patients |
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Hyeong Ki Shim , Hae Kwan Park , Chul Bum Cho, Won Il Joo , Hyoung Kyun Rha , Choung Kee Cho, Kyoung Jin Lee , Chun Kun Park |
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Department of Neurosurgery, Catholic Neuroscience Center, St. Mary's Hospital Catholic University, Korea |
| 노인환자에서 다발성 뇌동맥류에 대한 임상적 고찰 |
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| Abstract |
Objective
With improvement in the technique of angiography and increasing experience in the interpretation of
the radiographs, the diagnosis of multiple intracranial aneurysms in the elderly patients has become much more
common. However, the multiple intracranial aneurysms in the elderly patients are not well established. We evaluated
a characteristic site distribution (including most common site of ruptured aneurysm) along the major vessels in the
multiple intracranial aneurysms.
Methods
Between 1997 and 2007, 60 patients (age, 24 to 79 years) with ruptured multiple intracranial aneurysm
were treated at our institution. Multiple aneurysms in the elderly patients were found in 20 of these patients. Aneurysm
location, determined with preoperative angiographic and surgical reports, were reviewed. Age- and sex- specific
ruptured site of SAH patients with mutiple intracranial aneurysms was evaluated.
Result: Between 1997 and 2007, SAH caused by ruptured intracranial multiple aneurysm was confirmed in 60
patients 24 to 79 years of age and 142 aneurysms. The male to female ratio was about 1:4 (male : female = 12 : 48) for
patients with multiple intracranial aneurysms and 1:4.9 (male : female = 24 : 118) for number of aneurysms. Onehundred-
and-eight of 142 multiple intracranial aneurysms (83.1%) were present in women. Middle cerebral artery was
the most common site of multiple intracranial aneurysms. Posterior communicating artery was the most common
site of aneurysm rupture (40%) and aneurysm formation (33.3%) in the elderly patients. Four of 5 A-comm. aneurysms
in elderly women patients were ruptured aneurysms. Among 20 elderly patients with multiple intracranial aneurysms,
ruptured aneurysms of posterior circulation were not seen.
Conclusion
Posterior communicating artery seems to be frequent site of multiple intracranial aneurysms in elderly
patients who have suffered a subarachnoid hemorrhage. The rate of aneurysm rupture in the A-comm. was significantly
higher than that in the P-comm. or MCA in both men and women. |
| Key Words:
Multiple intracranial aneurysms⋅Eelderly⋅Rate of aneurysm rupture |
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