[Clinical analysis of 60 aged patients with ruptured intracranial aneurysms].
Sixty cases with ruptured intracranial aneurysms over 65 years of age were classified as aged group and were compared with 81 cases (control group) between 50 and 59 years of age. The results obtained are as followed: 1. Aneurysms in aged group occur frequently in female (83%) and in internal carotid artery (42%). 2. Cases with "Excellent" operative result in aged group was found significantly lower in ratio (34%) than in control group (59%), which seems attributable to high incidence of their poor results in the cases with serious conditions (Hunt and Kosnik Grade III & VI) and in those operated early after episode of hemorrhage. 3. Symptomatic vasospasm and primary brain damage due to subarachnoid hemorrhage occurred frequently in aged group (22% and 8%, respectively), and are proved to be two major causes of their unfortunate outcome. 4. In aged group difficulty in full enforcement due to cardiovascular complications was considered to make hypervolemia-hypertension therapy less effective to prevent and improve ischemia symptoms due to vasospasm. Accordingly, one has to choose such other means as meticulous and almost complete removal of subarachnoid hematoma in early operation or by some drainage systems. 5. Although the primary brain damage occurred in similar frequency in both aged and control groups, its recovery was significantly lower in aged group than in the control. Under the sustaining conditions of the primary brain damage, one should take care of latently progressing intracranial pathology such as vasospasm.
Nagasawa
S
S
Department of Neurosurgery, Kyoto University Medical School, Japan.
Ohtsuki
H
H
Yonekawa
Y
Y
Handa
H
H
D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000209:etiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012422:Rupture, Spontaneous