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Managcment of Elderly Patients with Aneurysmal Subarachnoed Hemorrhage Toshihiro YASUI 1 , Hisatsugu YAGURA 1 , Masaki KOMIYAMA 1 , Yoshihiko FU 1 , Katsuhiko TAMURA 1 , Yasunori NAGATA 1 , An myong KIM 1 , Shuro NISHIMURA 2 1Department of Neurosurgery, Baba Memorial Hospital 2Department of Neurosurgery, Osaka City University Medical School Keyword: Aged patients , Aneurysm , Cerebral vasospasm , Subarachnoid hemorrghae pp.651-656
Published Date 1992/6/10
DOI https://doi.org/10.11477/mf.1436900473
  • Abstract
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Clinical features of 61 elderly patients aged over 70 years with ruptured intracranial aneurysms were com-pared with those of 328 younger patients aged under 70 years. According to a policy of early operation, elderly patients with Hunt and Kosnik's grade I, II and youn-ger patients with grade I, II, III were operated on in the acute stage. In elderly patients with grade III, IV and younger patients with grade IV, the indication for surgery was determined case by case. Surgery was per-formed on 29 patients (48%) in the elderly group and 277 patients (86%) in the younger group. Our conclu-sions are as follows :

1. Regarding cases of grade I, II and III of Hunt and Kosnik's classification, the rate of good outcome in the elderly group was similar to that in the younger group, following early surgery and meticulous post- operative care.

2. In the elderly group, no patient in cases of grade IV obtained good surgical outcome.

3. Symptomatic vasospasm was less frequent in elderly patients (18.8%) than in younger cases (37%).

4. Delayed operation was planned for some patients in the elderly group, but none of them underwent surgery because of rerupture of aneurysms and de- terioration of general condition.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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