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[Aneurysms surgery in the patients aged seventy to eighty years]
S D Vega-Basulto1, S Silva-Adán, G Mosquera-Betancourt
1Departmento de Neurocirugía, Hospital Provincial Manuel Ascunce Doménech, Camagüey, Cuba.
Neurocirugia (Asturias, Spain)
|November 22, 2002
Summary
Surgical intervention for ruptured intracranial aneurysms in elderly patients (older than 60) can yield good outcomes. Age should not be a barrier to surgery for geriatric patients with good clinical grades.
Area of Science:
- Neurosurgery
- Geriatric Medicine
- Vascular Neurology
Context:
- The global elderly population is increasing, particularly in developing nations.
- Subarachnoid hemorrhage from ruptured aneurysms in geriatric patients has high mortality.
- Few elderly patients are selected for surgical treatment of intracranial aneurysms.
Purpose:
- To evaluate the safety and efficacy of surgical treatment for intracranial aneurysms in elderly patients (over 60 years old).
- To determine if age alone is a contraindication for surgical intervention in geriatric patients with ruptured aneurysms.
Summary:
- A study at Manuel Ascunce Domenech Hospital reviewed 1112 patients over 60, identifying 96 with symptomatic intracranial aneurysms.
- Thirty patients in clinical grades I-II (World Federation of Neurosurgical Societies - WFNS) underwent surgery, with aneurysm size/location not being exclusion criteria.
- Aneurysms were primarily located at the posterior communicating and middle cerebral arteries. Two deaths occurred (one medical, one surgical).
- Six months post-operation, 74% of patients achieved satisfactory outcomes, demonstrating the potential for successful surgical management in carefully selected elderly individuals.
Impact:
- Highlights the importance of considering elderly patients for surgical treatment of intracranial aneurysms.
- Suggests that age should not be a limiting factor if patients have good clinical status (WFNS grade).
- Emphasizes the role of advanced techniques, stroke units, patient selection, and minimally invasive surgery in improving results for geriatric neurosurgical patients.