Kin H, Mizukami M, Araki G, Mihara H
No Shinkei Geka. 1975 Jul;3(7):571-6.
Outcome of 77 cases with ruptured intracranial aneurysms above 60 years of age was reported. 44 cases were treated conservatively and 33 cases surgically. 1. Among conservatively treated group, 10 cases died after initial hemorrhage and 14 cases after second hemorrhage. The mortality rate was 55%. 2. Among surgically treated group, 11 cases died and 4 cases had severe neurological deficits following the direct intracranial operation. The mortality and morbidity rate was 33% and 12% respectively. 3. These results indicate that the direct intracranial operation should be the first choice of treatment to the aged patients also. 4. Intracranial complications occured more frequently than the extracranial one during intra and postoperative course. Among them normal pressure hydrocephalus was the comonnest. 5. Occlusion of the main cerebral artery occured in 5 cases related to operative procedure. Outcome of 4 cases of them was poor. Microsurgical technique should be used in order to prevent these conditions which tend to occur in aged patients.
报告了77例60岁以上颅内动脉瘤破裂患者的治疗结果。44例采用保守治疗,33例接受手术治疗。1. 在保守治疗组中,10例在首次出血后死亡,14例在二次出血后死亡。死亡率为55%。2. 在手术治疗组中,11例死亡,4例在颅内直接手术后出现严重神经功能缺损。死亡率和发病率分别为33%和12%。3. 这些结果表明,颅内直接手术也应是老年患者的首选治疗方法。4. 颅内并发症在术中及术后比颅外并发症更频繁发生。其中正常压力脑积水最为常见。5. 5例因手术操作导致大脑主要动脉闭塞。其中4例预后不良。应采用显微外科技术以预防这些在老年患者中易发生的情况。