Surgical Treatment of Intracranial Aneurysms in Elderly

Abstract

Introduction: Twenty years ago, elderly patients who had a diagnosis of intracerebral aneurysms were considered to have a poor prognosis and, thus, were excluded of any kind of treatment. With the rapid aging of the population, there was a consistent increase on the prevalence of subarachnoid hemorrhage and, consequently, all of its complications. Delayed neurological deterioration from cerebral arterial vasospasm is a major cause of morbidity and mortality. Thus, specific treatment strategy for intracranial aneurysms in the elderly has been developed. Materials and Methods: Analysis of medical records, office charts, and imaging studies of all elderly patients who underwent surgical treatment of intracerebral aneurysms, and review of literature. Data related to these patients, like gender, aneurysm location, rupture, and comorbidities, were recorded. Results: Between June 1996 and November 2009, among 152 patients with 209 ruptured and unruptured intracranial aneurysms treated surgically, 23 patients were 65 years of age or older. Discussion: Withholding aneurysm surgery merely because of the patient’s age is not necessarily the most appropriate decision. Early surgery, in order to avoid re-rupture, vasospasm and infection, still is the better decision, independently of the treatment modality - open surgery or endovascular.