Surgical management of unruptured cerebral aneurysms in the elderly: An institution experience

Cheikh, Abderrahmane; Kasinathan, Sudhakar; Yamada, Yoshihiko; Kawase, Tsukasa; Kato, Yoshihiro

doi:10.4103/ajns.ajns_233_18

“…IAs in the elderly population are not very well documented due to a lack of large-sample studies. In addition, existing studies have mainly focused on patients with unruptured aneurysms [6][7][8][9]. Subsequently, the overall characteristics of IAs in elderly patients remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of intracranial aneurysms in elderly patents over 70 years old: a retrospective observational study

Chen

¹

,

Wen

²

,

Xiao

³

et al. 2022

BMC Neurol

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Background Although the characteristics of intracranial aneurysms (IAs) in different age groups have been well documented, they remain relatively unclear in elderly patients due to a lack of large sample studies. Methods Data from IA patients aged more than 70 years who were treated in our centre from January 2016 to January 2020 were retrospectively collected. Results A total of 290 elderly patients (75.9% female) with a mean age of 74.0 ± 4.7 years were analysed. Rupture occurred in 60.7% of patients, 38.6% of whom presented with meningeal irritation, and seizures were noted in 2.3%. A total of 48.9% of the patients with ruptured IAs had initial symptoms presenting with slow development, and the mean delay from ictus was prolonged to 264.2 ± 914.0 hours. In addition, 61.9% of the patients with ruptured IAs had lesions with a maximum diameter of less than 5 mm. A total of 30.3% of the patients had multiple aneurysms, 35.5% had aneurysms with irregular shapes and 54.8% had cerebrovascular atherosclerotic stenosis (CAS). Pulmonary infection (n = 138, 47.6%), hydrocephalus (n = 72, 24.8%), and thrombosis (n = 35, 12.1%) were common complications during hospitalization. By the end of the 1-year follow-up, 22.1% of the patients had unfavourable clinical outcomes, and the mortality rate was 23.4%. Conclusions Several characteristics regarding IAs in elderly patients were reported, including an obvious female predominance; mild, slow initial symptom development causing prolonged admission delay; a low incidence of meningeal irritation and seizures due to decreased electrophysiological activity of the neurons; increased percentages of CAS, multiple aneurysms, and aneurysms with daughter sacs causing a high risk of rupture even for small lesions; a high risk of complications during hospitalization; and relatively poor clinical outcomes.

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“…IAs in the elderly population are not very well documented due to a lack of large-sample studies. In addition, existing studies have mainly focused on patients with unruptured aneurysms [9][10][11][12] . Subsequently, the overall characteristics of IAs in elderly patients remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Intracranial Aneurysms in Elderly Patents over 70 Years Old: a retrospective observational study

Chen

¹

,

Wen

²

,

Xiao

³

et al. 2022

Preprint

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Background Although the characteristics of intracranial aneurysms (IAs) in different age groups have been well documented, they remain relatively unclear in elderly patients due to a lack of large sample studies. Methods Data from IA patients aged more than 70 years who were treated in our centre from January 2016 to January 2020 were retrospectively collected. Results A total of 290 elderly patients (75.9% female) with a mean age of 74.0 ± 4.7 years were analysed. Rupture occurred in 60.7% of patients, 38.6% of whom presented with meningeal irritation, and seizures were noted in 2.3%. A total of 48.9% of the patients with ruptured IAs had initial symptoms presenting with slow development, and the mean delay from ictus was prolonged to 264.2 ± 914.0 hours. In addition, 61.9% of the patients with ruptured IAs had lesions with a maximum diameter of less than 5 mm. A total of 30.3% of the patients had multiple aneurysms, 35.5% had aneurysms with irregular shapes and 54.8% had cerebrovascular atherosclerotic stenosis (CAS). Pulmonary infection (n = 138, 47.6%), hydrocephalus (n = 72, 24.8%), and thrombosis (n = 35, 12.1%) were common complications during hospitalization. By the end of the 1-year follow-up, 22.1% of the patients had unfavourable clinical outcomes, and the mortality rate was 23.4%. Conclusions Several characteristics regarding IAs in elderly patients were reported, including an obvious female predominance; mild, slow initial symptom development causing prolonged admission delay; a low incidence of meningeal irritation and seizures due to decreased electrophysiological activity of the neurons; increased percentages of CAS, multiple aneurysms, and aneurysms with daughter sacs causing a high risk of rupture even for small lesions; a high risk of complications during hospitalization; and relatively poor clinical outcomes.

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Impact of aneurysm location and endovascular treatment modality on the improvement of headache in patients with unruptured intracranial aneurysms

Dibas

¹

,

Ghozy

²

,

El‐Qushayri

³

et al. 2020

J Neurosurg Sci

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Surgical management of unruptured cerebral aneurysms in the elderly: An institution experience

Cited by 3 publications

References 22 publications

Clinical characteristics of intracranial aneurysms in elderly patents over 70 years old: a retrospective observational study

Clinical characteristics of intracranial aneurysms in elderly patents over 70 years old: a retrospective observational study

Clinical Characteristics of Intracranial Aneurysms in Elderly Patents over 70 Years Old: a retrospective observational study

Impact of aneurysm location and endovascular treatment modality on the improvement of headache in patients with unruptured intracranial aneurysms

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