[Therapeutic problems in aged patients with intracranial aneurysms]

Area of Science:

• Neurosurgery
• Geriatric Medicine
• Vascular Neurology

Context:

• Intracranial saccular aneurysms pose significant risks, particularly in elderly patients.
• Surgical outcomes and complications in patients over 65 require specific consideration.
• Comparative analysis of surgical outcomes between elderly and younger patients is crucial for optimizing treatment strategies.

Purpose:

• To compare the operative mortality, complications, and long-term outcomes of intracranial saccular aneurysm surgery in patients over 65 versus those under 65.
• To investigate the incidence and impact of vasospasm, cerebral infarction, and hydrocephalus in elderly versus younger patients.
• To assess the need for ventriculo-peritoneal shunts in different age groups following aneurysm surgery.

Summary:

• Operative mortality was higher in aged patients (11.8%) compared to younger patients (6.1%).
• Severe cerebral infarction occurred more frequently in the aged (92.9% vs 58%), though it was non-fatal.
• Aged patients showed a higher requirement for ventriculo-peritoneal shunts (82.4% vs 39.3%) when ventricular dilatation was present.

Impact:

• Findings highlight increased risks for elderly patients undergoing intracranial aneurysm surgery, necessitating tailored perioperative management.
• The study underscores the higher likelihood of severe complications and need for shunting in older individuals.
• Results inform clinical decision-making regarding surgical intervention and postoperative care for geriatric neurosurgical patients.