A Comparative Surgical Outcome Study between Below and Above 60 Year-old Patients in Intracranial Aneurysms

ABSTRACT

OBJECTIVE: The author divide the patients of cerebral aneurysm into two groups, those under and over sixty years of age, and analyze retrospectively how the ages of patients influence the outcome after the operation. METHODS: Among the patients who underwent surgical treatments for aneurysmal rupture at Dankook University Hospital between June, 1994 and June, 1999, the author took 151 cases in which postoperative follow up was possible over 6 months. After dividing them into the young and old aged groups, the author analyzed, clinical characteristics, postoperative results, complications, and the overall prognosis using Glasgow outcome scale of each group. RESULTS: Comparatively young age group to old age group ratio was 84:67, and the old aged group showed higher occurrence in women. Age distribution ranged from 19 to 78 years of age. According to Hunt-Hess grade measured at the time of admission, there was higher proportion of grade II and III in both groups, and according to Fisher grade based on brain CT scan, there was a higher proportion of grade III in both groups. In the young aged group, aneurysm was found in middle cerebral artery(MCA), anterior cerebral artery(ACA) and posterior cerebral artery(PCA) in the order of frequency. In the old aged group, aneurysm of PCA was most common followed by that of ACA and MCA. There was no higher prevalence of post-operative complications among old aged patients except for the occurrence of hydrocephalus. The outcome of patients assessed 6 months after the operation showed that the prognosis depended more on the Hunt - Hess grade and Fisher grade at the time of admission rather than the difference in age. CONCLUSION: Except for the occurrence of hydrocephalus in the old aged group, age did not seem to in-fluence the occurrence of post-operative complications after surgical treatment of aneurysm. Such findings warrant on aggressive surgical treatment for brain aneurysm in older patients.