| Elective neck clipping for unruptured aneurysms in elderly patients. | |
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MedLine Citation:
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PMID: 10697229 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: With the recent advancements of neuroimaging techniques, the number of unruptured aneurysms diagnosed in elderly patients has increased. However, the surgical indications in this special subgroup have not been studied critically. The purposes of this study were to analyze the results of elective neck clipping surgery for unruptured aneurysms in the elderly and to elucidate the surgical indications. METHODS: From 1985 to 1997, 96 patients, aged 70 years or older, with 103 unruptured cerebral aneurysms underwent elective neck clipping. There were 67 females and 29 males. Their ages ranged from 70 to 86, with a mean of 73.3 years. Seventy-five aneurysms were asymptomatic and 28 were symptomatic. The aneurysms were located on the internal carotid artery (46.6%), middle cerebral artery (35.9%), anterior cerebral artery (16.5%), and basilar artery (1.0%). RESULTS: The surgical outcome was a good recovery in 75 patients (78.1%), mild deficits in 12 (12.5%), severe deficits in 4 (4.2%), and death in 5 (5.2%). Recovery from preoperative symptoms with improved quality of life was seen in 22 (78.6%) of the 28 symptomatic cases. Multiple regression analysis showed that increase in the size of aneurysms and location on the middle cerebral artery and internal carotid artery were significantly related to a poor outcome. The causes of the five deaths were hemorrhagic infarction, systemic infection, and myocardial infarction. CONCLUSION: Surgery for elective neck clipping of unruptured aneurysms in the elderly should be considered in symptomatic patients with simple aneurysms that can be clipped without the use of temporary clips. |
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Authors:
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S Kashiwagi; K Yamashita; S Kato; T Takasago; H Ito |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgical neurology Volume: 53 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2000 Jan |
Date Detail:
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Created Date: 2000-03-08 Completed Date: 2000-03-08 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 14-20 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Female Humans Intracranial Aneurysm / pathology, surgery* Male Patient Selection* Regression Analysis Risk Factors Surgical Procedures, Elective* Treatment Failure Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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