Surgery and long-term outcome for ruptured anterior circulation aneurysms in patients in their ninth decade of life.
BACKGROUND
The present pilot study was undertaken to analyze the long-term results of surgery for ruptured anterior circulation aneurysms in patients in their 9th decade of life.


METHODS
Between 1992 and 1997, we treated 10 consecutive patients with ruptured anterior circulation aneurysms who were 80 years or older on admission and judged eligible for surgery based on stringent criteria. The outcomes at discharge and the latest outcomes (obtained at a median of 41.6 months) were assessed using the Glasgow Outcome Scale and the Barthel Score, respectively.


RESULTS
Upon discharge, six of the 10 patients showed good recovery, two patients were moderately disabled, and two patients who suffered symptomatic vasospasm were severely disabled. As for the latest outcomes, assessed using Barthel Score, four patients had the maximum score of 100, two a score of 90, one a score of 35, two a score of 10, and one patient died. Of four patients who were in poor condition, two experienced deterioration attributable to unrelated causes 18 and 32 months after the ictus.


CONCLUSIONS
Advanced age alone does not preclude successful surgery for ruptured anterior circulation aneurysms. Carefully selected patients over 80 years should also be considered for surgical treatment.
Hamada
J
J
Department of Neurosurgery, Kumamoto University Medical School, Japan.
Hasegawa
S
S
Kai
Y
Y
Morioka
M
M
Fujioka
S
S
Ushio
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome