RUPTURED CEREBRAL ANEURYSM AFTER THE AGE OF 70: SURVIVAL AND FUNCTIONAL OUTCOME.
Objective: Observational retrospective study of all 63 individuals aged over 70 years with rupture of a saccular intracranial aneurysm admitted during the calendar years 2002 to 2004 with emphasis on functional outcome. Patients and methods: The mean age was 75.2 with range from 70.1 to 85.7 years. Aneurysm repair was performed in 53 patients. Ten patients had no repair. In September 2005 self-assessment health status questionnaires including the SF-36 were mailed to all 35 survivors believed to be fluent in the Norwegian. The survival statistics was updated on June 15, 2007. Results: The 6 mnd's mortality following aneurysm repair was 26 or 41% (CI95 29 % - 54 %). Of the 10 individuals whose aneurysm was not repaired, 8 (80%) had died (CI95 44 % - 98 %); their median survival was nine days. Completed questionnaires were returned from 32 of 35 probands, for a 91 % return rate. Of the survivors 21 (68%) live in their own home, and 16 (52%) can use public transport without an aid. 39% of the respondents reported having made a full recovery. The mean Rankin score was 2.3, with a median score of 2. Symptoms of anxiety and depression were rare.Conclusion: The outlook is grim for individuals aged over 70 years without the repair of a ruptured intracranial aneurysm. Aneurysm repair (by KRX or EVT) seems to give survivors the prospect of a favourable functional outcome. This study does not support the idea that individuals over the age of 70 years should be denied microsurgical or endovascular aneurysm repair on grounds of chronological age alone.