Skip to main content
Log in

Multiple intracranial aneurysms in elderly patients

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The clinical characteristics of elderly patients with multiple intracranial aneurysms were studied. A total of 481 patients, in whom the exact location of their ruptured aneurysms could be confirmed, were classified into two age groups, that is, those aged 59 years or younger (group 1: 247 cases, 51%) and those aged 60 years or older (group 2: 234 cases, 49%). The incidences of multiple aneurysms were 30% for group 1 and 27% for group 2. This difference is statistically not significant. The rate of multiple aneurysms was less frequent in males than in females in group 2, whereas no difference could be found in group 1. The age distribution of patients with multiple aneurysms was basically similar to that of patients with single aneurysms. While the highest rupture rate was observed in the anterior communicating artery aneurysms of both groups, this tendency was more prominent in group 2(79%) than in group 1 (59%). The rupture rates for other sites in group 2 were 50% for distal anterior cerebral artery aneurysms, 40% for internal carotid artery aneurysms and 28% for middle cerebral artery aneurysms. The pattern of surgical outcome showed no major differences between multiple and single aneurysms in either group 1 or 2. However, group 1 had better surgical results than group 2.

Even though the surgical outcome for multiple aneurysms in elderly patients was satisfactory, awareness of the probability of rupture at each site is helpful, especially when it is necessary to decide whether unruptured aneurysms should be operated on or not.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Andrews RJ, Spiegel PK (1979) Intracranial aneurysms: age, sex, blood pressure, and multiplicity in an unselected series of patients. J Neurosurg 51: 27–32

    PubMed  Google Scholar 

  2. Brisman R (1985) Management of multiple and asymptomatic aneurysms. In: Fein JM, Flamm ES (eds) Cerebrovascular surgery, Vol 3. Springer, New York, pp 983–995

    Google Scholar 

  3. Crompton MR (1966) Mechanism of growth and rupture in cerebral berry aneurysms. Br Med J 1: 1138–1142

    Google Scholar 

  4. Fogelholm R (1981) Subarachnoid hemorrhage in Middle-Finland: incidence, early prognosis and indications for neurosurgical treatment. Stroke 12: 296–301

    PubMed  Google Scholar 

  5. Heiskanen O (1965) The identification of ruptured aneurysm in patients with multiple intracranial aneurysms. Neurochirurgia (Stuttg) 8: 102–107

    Google Scholar 

  6. Heiskanen O (1981) Risk of bleeding from unruptured aneurysms in cases with multiple intracranial aneurysms. J Neurosurg 55: 524–526

    PubMed  Google Scholar 

  7. Heiskanen O (1986) Risks of surgery for unruptured intracranial aneurysms. J Neurosurg 65: 451–453

    PubMed  Google Scholar 

  8. Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28: 14–20

    PubMed  Google Scholar 

  9. Inagawa T, Hirano A (1990) Ruptured intracranial aneurysms: an autopsy study of 133 patients. Surg Neurol 33: 117–123

    PubMed  Google Scholar 

  10. Inagawa T, Hirano A (1990) An autopsy study of unruptured incidental intracranial aneurysms. Surg Neurol (in press)

  11. Inagawa T, Ishikawa S, Aoki H, Takahashi M, Yoshimoto H (1988) Aneurysmal subarachnoid hemorrhage in Izumo City and Shimane Prefecture of Japan. Incidence. Stroke 19: 170–175

    Google Scholar 

  12. Inagawa T, Takahashi M, Aoki H, Ishikawa S, Yohsimoto H (1988) Aneurysmal subarachnoid hemorrhage in Izumo City and Shimane Prefecture of Japan. Outcome. Stroke 19: 176–180

    Google Scholar 

  13. Inagawa T, Yamamoto M, Kamiya K, Ogasawara H (1988) Management of elderly patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 69: 332–339

    PubMed  Google Scholar 

  14. Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480–484

    PubMed  Google Scholar 

  15. Joensen P (1984) Subarachnoid hemorrhage in an isolated population. Incidence on the Faroes during the period 1962–1975. Stroke 15: 438–440

    PubMed  Google Scholar 

  16. Kassell NF, Torner JC (1983) Size of intracranial aneurysms. Neurosurgery 12: 291–297

    PubMed  Google Scholar 

  17. Kiyohara Y, Ueda K, Hasuo Y, Wada J, Kawano H, Kato I, Sinkawa A, Ohmura T, Iwamoto H, Omae T, Fujishima M (1989) Incidence and prognosis of subarachnoid hemorrhage in a Japanese rural community. Stroke 20: 1150–1155

    PubMed  Google Scholar 

  18. McKissock W, Richardson A, Walsh L, Owen E (1964) Multiple intracranial aneurysms. Lancet 1: 623–626

    Google Scholar 

  19. Mizoi K, Suzuki J, Yoshimoto T (1989) Surgical treatment of multiple aneurysms: review of experience with 372 cases. Acta Neurochir (Wien) 96: 8–14

    Google Scholar 

  20. Mount LA, Brisman R (1971) Treatment of multiple intracranial aneurysms. J Neurosurg 35: 728–730

    PubMed  Google Scholar 

  21. Moyes P (1971) Surgical treatment of multiple aneurysms and of incidentally-discovered unruptured aneurysms. J Neurosurg 35: 291–295

    Google Scholar 

  22. Nehls DG, Flom RA, Carter LP, Spetzler RF (1985) Multiple intracranial aneurysms: determining the site of rupture. J Neurosurg 63: 342–348

    PubMed  Google Scholar 

  23. Norlén G, Olivecrona H (1953) The treatment of aneurysms of the circle of Willis. J Neurosurg 10: 404–415

    PubMed  Google Scholar 

  24. Østergaard JR, Høg E (1985) Incidence of multiple intracranial aneurysms: influence of arterial hypertension and gender. J Neurosurg 63: 49–55

    PubMed  Google Scholar 

  25. Paterson A, Bond MR (1973) Treatment of multiple intracranial arterial aneurysms. Lancet 1: 1302–1304

    PubMed  Google Scholar 

  26. Phillips LH II, Whisnant JP, O'Fallon M, Sundt TM Jr (1980) The unchanging pattern of subarachnoid hemorrhage in a community. Neurology 30: 1034–1040

    PubMed  Google Scholar 

  27. Sacco RL, Wolf PA, Bharucha NE, Meeks SL, Kannel WB, Charette LJ, McNamara PM, Palmer EP, D'Agostino R (1984) Subarachnoid and intracerebral hemorrhage: natural history, prognosis, and precursive factors in the Framingham Study. Neurology 34: 847–854

    PubMed  Google Scholar 

  28. Sahs AL, Perret GE, Locksley HB, Nishioka H (1969) Intracranial aneurysms and subarachnoid hemorrhage: a cooperative study. JB Lippincott, Philadelphia

    Google Scholar 

  29. Salazar JL (1980) Surgical treatment of asymptomatic and incidental intracranial aneurysms. J Neurosurg 53: 20–21

    PubMed  Google Scholar 

  30. Samson DS, Hodosh RM, Clark WK (1977) Surgical management of unruptured asymptomatic aneurysms. J Neurosurg 46: 731–734

    PubMed  Google Scholar 

  31. Stehbens WE (1983) The pathology of intracranial arterial aneurysms and their complications. In: Fox JL (ed) Intracranial aneurysms. Vol 1. Springer, New York, pp 272–357

    Google Scholar 

  32. Suzuki J, Sakurai Y (1979) The treatment of intracranial multiple aneurysms. In: Suzuki J (ed) Cerebral aneurysms. Neuron Co., Tokyo, pp 293–307

    Google Scholar 

  33. Vajda J, Juhàsz J, Orosz E, Pàsztor E, Tòth Sz, Horvàth M (1986) Surgical treatment of multiple intracranial aneurysms. Acta Neurochir (Wien) 82: 14–23

    Google Scholar 

  34. Wiebers DO, Whisnant JP, O'Fallon WM (1981) The natural history of unruptured intracranial aneurysms. N Engl J Med 304: 696–698

    PubMed  Google Scholar 

  35. Wiebers DO, Whisnant JP, Sundt TM Jr, O'Fallon WM (1987) The significance of unruptured intracranial saccular aneurysms. J Neurosurg 66: 23–29

    PubMed  Google Scholar 

  36. Winn HR, Almaani WS, Berga SL, Jane JA, Richardson AE (1983) The long-term outcome in patients with multiple aneurysms: incidence of late hemorrhage and implications for treatment of incidental aneurysms. J Neurosurg 59: 642–651

    PubMed  Google Scholar 

  37. Wirth FP, Laws ER Jr, Piepgras D, Scott RM (1983) Surgical treatment of incidental intracranial aneurysms. Neurosurgery 12: 507–511

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Inagawa, T. Multiple intracranial aneurysms in elderly patients. Acta neurochir 106, 119–126 (1990). https://doi.org/10.1007/BF01809453

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01809453

Keywords

Navigation