gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Management of patients with ruptured cerebral aneurysms older than 65 years

Behandlung der Patienten mit aneursmatischer SAB in der Altersgruppe > 65 Jahre

Meeting Abstract

  • corresponding author Sebastian Lücke - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum
  • C. Brenke - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum
  • M. Engelhard - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum
  • M. Scholz - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum
  • K. Schmieder - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum
  • A. G. Harders - Department of Neurosurgery, Ruhr-Universität Bochum, Bochum

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.07.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0076.shtml

Veröffentlicht: 23. April 2004

© 2004 Lücke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Outcome of elderly patients with SAH is known to be less favourable than in younger patients [Inagawa et al]. Lanzino reported that the incidence of vasospasm is lower, but more often a symptomatic vasospasm is present in the elderly. In the scale of Hunt age is noted to be a factor that elevates the surgical risk. Therefore, we investigated our treatment results in this age group and the decision making wether to operate or not and the timing of intervention.

Methods

From 7/1993 until 12/2002 all patients older than 65 years with ruptured aneurysms treated either surgically/ endovascular/ conservative in our department were entered in the study. Severity of the SAH was graded according to the Hunt&Hess scale and the Fisher score. Furthermore, the location of the aneurysms was registered. Outcome was measured with the Glasgow-Outcome-Scale. Results were compared with outcome of all patients treated in our deparment with aneurysmal SAH.

Results

From 7/1993 until 12/2002 103 patients older than 65 years (range 66-85 years) with ruptured aneurysms were treated. Clipping of one or more aneurysm were performed in 95 cases, one VA and one PICA aneurysm were coiled. Six patients had been treated conservative cause of the poor neurological state on admission. Good recovery (GOS 1-3) showed 70%, a poor outcome (GOS 4+5) 30%. ICH on initial ct-scan was followed by poor outcome.

Conclusions

Patients in this study aged >65 years showed a severe SAH in most cases, in 18% combined with a space occupying ICH. According to the literature this is a predictor of a less favourable outcome. Nonetheless, a large number of patients made a good recovery in this study. Patients graded H&H V in this age do not recover.