1987 Volume 27 Issue 11 Pages 1066-1072
Clinical features of 70 elderly patients (over age 65) with ruptured intracranial aneurysms were compared with those of 70 middle-aged patients (45 to 55 years old) with similar clinical grades. Postoperative complications were particularly noted. There were more females and a higher incidence of internal carotid artery aneurysms in the elderly than in the middle-aged group. Contrary to expectation, the frequency of rebleeding was 45% among the elderly patients who received conservative therapy. The mortality rate among elderly patients who underwent surgery was 12.5%, whereas it was 1.5% in the middle-aged group. The cause of poor outcome in the elderly group was cerebral infarction after severe vasospasm, although the incidence of symptomatic vasospasm was almost the same in both groups. Hyponatremia, gastrointestinal bleeding, and electrocardiographic abnormalities were more prevalent in the elderly group. Although intensive postoperative care may be required, an aggressive approach to treating ruptured intracranial aneurysms in the elderly is recommended.
