Intracranial arterial aneurysms

Summary

In a series of 300 patients with surgically treated intracranial saccular aneurysm, 43 were between 60 and 70 years of age. The surgical mortality in this age group was 9% and the morbidity was of the same order of magnitude. These figures are in essential agreement with the results from large series comprising all age groups. Thirty-eight patients have been followed up for one to nine years and at the time of this report 79% are either free from symptoms (66%) or have only minor disabilities (13%). No recurrent bleeding has occurred in patients in whom the aneurysm was ligated or reinforced with plastic coating. Experiences from this series show that the upper age limit for surgical treatment can be set at the end of the seventh decade if the following contraindications, referring to the brain itself, are observed: I. Prolonged initial unconsciousness in association with the rupture of the aneurysm. II. Clinical signs of cerebral arteriosclerosis before the onset of the haemorrhage. III. Angiographically verified arteriosclerosis in the cerebral vessels if this is pronounced. Arterial hypertension strengthens this contraindication.