[Subarachnoid hemorrhage from ruptured aneurysms in elderly patients].
Advanced age is a recognized risk factor in patients with SAH. A strong correlation has been found between advanced age and impairment of consciousness at admission, presence of thick subarachnoid clot, intraventricular hemorrhage and acute hydrocephalus. Thus suggesting a more severe disease in elderly. Moreover the incidence of rebleeding increases with advancing age. As to the results of surgery a linear correlation between age and outcome has been found in most of series and it is difficult to identify a critical age. However the rate of patients with a poor outcome is significantly higher when an age cut off 60-65 years is considered. Significant improvements have been obtained in the last 30 years in elderly but mortality rate still remains at high level: in the order of 20% in the patients 60-70 years old. For patients over 70 years only results from single series are available and these suggest favourable results in very selected cases. The introduction of GDC coil in the treatment of cerebral aneurysms has changed the management of most SAH patients and particularly of the older ones. The guidelines of current management of such patients followed at the Niguarda Hospital of Milan are presented. Age is one of the four "factors" taken into consideration for a selection of treatment (surgery or coil).
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Divisione di Neurochirurgia, Ospedale Niguarda Ca' Granda, Milano.
D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000209:etiology*
L'emorragia subaracnoidea da rottura di aneurisma nel paziente anziano.