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Unruptured intracranial aneurysms in elderly patients
1Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Surgical Neurology
|November 1, 1992
Summary
This study found that small intracranial aneurysms (<4mm) are more common in unruptured cases. The anterior communicating artery aneurysm rupture rate increases with age, highlighting site-specific rupture risk, especially in older patients.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Epidemiology
Background:
- Intracranial aneurysms pose significant health risks, with rupture leading to subarachnoid hemorrhage.
- Understanding factors influencing aneurysm rupture, such as size, location, and patient age, is crucial for clinical decision-making.
Purpose of the Study:
- To analyze the characteristics of ruptured and unruptured intracranial aneurysms in a large patient cohort.
- To investigate the relationship between aneurysm location, size, patient age, and rupture status.
- To evaluate the outcomes of surgical intervention for unruptured aneurysms, particularly in elderly patients.
Main Methods:
- Retrospective analysis of 769 intracranial aneurysms in 556 patients, categorized by rupture status (256 unruptured, 513 ruptured).
- Patients were stratified into three age groups: ≤59, 60–69, and ≥70 years.
- Follow-up data for 55 unruptured aneurysms and outcomes of direct surgical operations for 52 unruptured aneurysms were reviewed.
Main Results:
- Small aneurysms (≤4 mm) were more prevalent in the unruptured group.
- Anterior communicating artery aneurysms exhibited the highest rupture rate, which escalated with advancing age.
- Surgical treatment for unruptured aneurysms resulted in 0% mortality and 6% morbidity, independent of patient age.
Conclusions:
- Aneurysm location and patient age are critical determinants of rupture risk, particularly for anterior communicating artery aneurysms.
- Surgical intervention for unruptured aneurysms demonstrates favorable outcomes, with rupture risk at specific sites being a key consideration, especially in elderly individuals.