80歳以上の高齢者破裂脳動脈瘤の治療(<特集>高齢者重症くも膜下出血の急性期治療) Treatment for Ruptured Aneurysm of Aged Patients Over 80 Years Old(<Topics>Treatment for the Elderly with Severe SAH)

We analyzed the outcome of surgical treatment for ruptured cerebral aneurysm in 15 aged patients over 80 years old. The neurological grades on admission, according to the Hunt and Kosnik classification, were Grade II in 5 cases, Grade III in 5 cases, Grade IV in 3 cases, and Grade V in 2 cases, and were worse than those of younger patients. Ruptured aneurysm was treated by direct surgery in 8 cases and embolization in 2 cases. The Glasgow outcome scale at discharge was good recovery in 1, moderately disabled in 2, severely disabled in 7, vegetative state in 1, and dead in 4 cases. In cases treated by direct surgery or embolization, unfavorable outcome was caused by primary brain damage, disuse syndrome, and delayed vasospasm. We conclude that radical treatment of ruptured aneurysm in the acute stage and rehabilitation are vitally important in aged patients.