Surgery and long-term outcome for ruptured anterior circulation aneurysms in patients in their ninth decade of life

BACKGROUND The present pilot study was undertaken to analyze the long-term results of surgery for ruptured anterior circulation aneurysms in patients in their 9t h decade of life. METHODS Between 1992 and 1997, we treated 10 consecutive patients with ruptured ant erior circulation aneurysms who were 80 years or older on admission and jud ged eligible for surgery based on stringent criteria. The outcomes at disch arge and the latest outcomes (obtained at a median of 41.6 months) were ass essed using the Glasgow Outcome Scale and the Barthel Score, respectively. RESULTS Upon discharge, six of the 10 patients showed good recovery, two patients w ere moderately disabled, and two patients who suffered symptomatic vasospas m were severely disabled. As for the latest outcomes, assessed using Barthe l Score, four patients had the maximum score of 100, two a score of 90, one a score of 35, two a score of 10, and one patient died. Of four patients w ho were in poor condition, two experienced deterioration attributable to un related causes 18 and 32 months after the ictus. CONCLUSION Advanced age alone does not preclude successful surgery for ruptured anteri or circulation aneurysms. Carefully selected patients over 80 years should also be considered for surgical treatment. (C) 1999 by Elsevier Science inc .