Abstract
Background: The aging of the healthy population without severe morbidity exposes them to cerebrovascular diseases and demand effective management. This study aimed to study the prevalence of geriatric cerebrovascular neurosurgical conditions in the Neurosurgical Department at Khoula Hospital, Muscat, Sultanate of Oman. Methods: A retrospective chart review of was done on geriatric cases admitted to the Neurosurgery Department in Khoula Hospital as an example of a neurosurgical center in a high-income developing country from January 2016 to 31st December 2019. Patients’ demographics, risk factors, diagnosis, Glasgow Coma Scale (GCS) on arrival, medications used, and length of stay were recorded. Results: 109 patients aged over 65 years were recruited in our retrospective review with a mean age of 74.12 years. Male-to-female ratio was (1.2:1). Intracerebral hemorrhage (ICH) was the most common vascular diagnosis (39.0%) followed by subarachnoid hemorrhage (SAH) (22.9%). Most patients (41.9%) had a GCS score of less than 8. About one-fifth of the patients received antiplatelet and anticoagulant medications. Most of the patients underwent surgical intervention (61.9%). 59% of the patients stayed in the hospital for less than 15 days. There were significant associations between the length of stay, treatment types (surgical vs. conservative), and age (P<0.05). Conclusion: Cerebrovascular pathologies are a growing cause of mortality and morbidity worldwide including developing countries because of the increasing number of elderly people. Antiplatelet medication and anticoagulants should be used with caution in the elderly.
Highlights
The aging of the healthy population without severe morbidity exposes them to several vascular accidents such as subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), cerebral aneurysm because of fragility of the blood vessels, and other vascular pathologies associated with age that demand effective management.[1]
SAH is defined as direct extravasation of blood into the subarachnoid space caused by the rupture of lesional vessels located at the brain or surface.[2]
The condition is common in the elderly compared to the younger population due to parenchymal atrophy, which allows a large quantity of blood to collect after aneurysm rupture.[3]
Summary
The aging of the healthy population without severe morbidity exposes them to several vascular accidents such as subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), cerebral aneurysm because of fragility of the blood vessels, and other vascular pathologies associated with age that demand effective management.[1]. SAH is defined as direct extravasation of blood into the subarachnoid space caused by the rupture of lesional vessels located at the brain or surface.[2] Age has an independent negative influence on the outcome.[3] The condition is common in the elderly compared to the younger population due to parenchymal atrophy, which allows a large quantity of blood to collect after aneurysm rupture.[3] This accounts for 5% of all acute strokes.[3] Mortality rates as high as 45% have been reported.[3] Multiple risk factors are involved in SAH, including diabetes, myocardial disease, arterial hypertension, cerebrovascular and pulmonary disease, and smoking.[3] Aneurysmal SAH, is well-known to rise with age, especially in women.
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