患者の術前後および長期QOLからみた無症候性未破裂脳動脈瘤治療の妥当性(<特集>未破裂脳動脈瘤の治療方針)  [in Japanese] Validation of Surgical Treatment for Asymptomatic Unruptured Intracranial Aneurysms in View of Patient Quality of Life(<Topics> Management for Unruptured Cerebral Aneurysm)  [in Japanese]

Recently patient-based outcomes like quality of life (QOL) have been emphasized in the assessment, of several kinds of medical treatments. Little is known about QOL in patient.s who underwent elective operation for asymptomatic unruptured intracranial aneurysms. The present study aimed to determine how patient QOL changed before and after the elective operation of unruptured aneurysms. For 39 patients who underwent clipping surgery for asymptomatic unruptured intracranial aneurysms, QOL was assessed using Short, Form-36 (SF-36) before, 3 months after, and I year after the operation; and results were compared. For 147 patients treated surgically for aneurysms more than 2 years before. QOL was compared with that of Japanese reference population. Before operation, patient QOL declined for most domains of SF-36. Although daily-life QOL was still low 3 months after the operation, it returned to the level of reference population for most domains 1 year postoperatively. In respect of long-term QOL, scores of SF-36 in 147 patients remained at an average level; however, there were 20 (13.6%) patients with QOL below average. A statistical analysis showed that QOL was affected by history of heart, diseases, aneurysm size, and present activity. The present study showed that QOL improved and persisted at the reference level in the majority of patients after operation, supporting the validity of surgical treatment for asymptomatic unruptured intracranial aneurysms.