BACKGROUND AND PURPOSE: The incidence of poor-grade (Hunt and Hess grade IV and V) subarachnoid hemorrhage (SAH) is higher in elderly patients (>70 years) than in younger groups. The aim of this retrospective study was to analyze the outcome of these poor grade elderly patients after endovascular treatment. METHODS: We retrospectively reviewed the clinical records of 27 patients older than 70 years who underwent endovascular treatment for aneurysmal SAH between January 1996 and July 2002. Thirteen patients with SAH and a poor Hunt and Hess grade at initial presentation had been treated by endovascular means. Their outcomes were assessed by the using the Glasgow Outcome Scale (GOS). RESULTS: Two patients (15%) had a good outcome according to the GOS. Three patients (23%) were moderately disabled, two (15%) were severely disabled at the time of discharge from the hospital, and six (47%) died. Five patients (38%) developed clinical vasospasm and underwent balloon angioplasty. Three procedure-related deaths occurred (23%). CONCLUSION: Endovascular treatment has modified the management of poor-grade SAH in elderly patients, most of whom are high-risk surgical candidates. Endovascular treatment can be administered early after the initial ictus, reducing the risk of rebleeding and providing an option to pursue aggressive triple-H therapy. Symptomatic vasospasm can also be treated by endovascular means in the initial setting.
BACKGROUND AND PURPOSE: The incidence of poor-grade (Hunt and Hess grade IV and V) subarachnoid hemorrhage (SAH) is higher in elderly patients (>70 years) than in younger groups. The aim of this retrospective study was to analyze the outcome of these poor grade elderly patients after endovascular treatment. METHODS: We retrospectively reviewed the clinical records of 27 patients older than 70 years who underwent endovascular treatment for aneurysmalSAH between January 1996 and July 2002. Thirteen patients with SAH and a poor Hunt and Hess grade at initial presentation had been treated by endovascular means. Their outcomes were assessed by the using the Glasgow Outcome Scale (GOS). RESULTS: Two patients (15%) had a good outcome according to the GOS. Three patients (23%) were moderately disabled, two (15%) were severely disabled at the time of discharge from the hospital, and six (47%) died. Five patients (38%) developed clinical vasospasm and underwent balloon angioplasty. Three procedure-related deaths occurred (23%). CONCLUSION: Endovascular treatment has modified the management of poor-grade SAH in elderly patients, most of whom are high-risk surgical candidates. Endovascular treatment can be administered early after the initial ictus, reducing the risk of rebleeding and providing an option to pursue aggressive triple-H therapy. Symptomatic vasospasm can also be treated by endovascular means in the initial setting.
Authors: Y Murayama; T Malisch; G Guglielmi; M E Mawad; F Viñuela; G R Duckwiler; Y P Gobin; R P Klucznick; N A Martin; J Frazee Journal: J Neurosurg Date: 1997-12 Impact factor: 5.115
Authors: G Lanzino; N F Kassell; T P Germanson; G L Kongable; L L Truskowski; J C Torner; J A Jane Journal: J Neurosurg Date: 1996-09 Impact factor: 5.115
Authors: R L Sacco; P A Wolf; N E Bharucha; S L Meeks; W B Kannel; L J Charette; P M McNamara; E P Palmer; R D'Agostino Journal: Neurology Date: 1984-07 Impact factor: 9.910
Authors: S R Kim; N Vora; T G Jovin; R Gupta; A Thomas; A Kassam; K Lee; Y Gologorsky; B Jankowitz; N Panapitiya; A Aleu; E Sandhu; E Crago; A Hricik; M Gallek; M B Horowitz Journal: Interv Neuroradiol Date: 2008-10-08 Impact factor: 1.610
Authors: Adam Gittins; Nick Talbott; Ahmed A Gilani; Greg Packer; Richard Browne; Randeep Mullhi; Zaheed Khan; T Whitehouse; Antonio Belli; Rajnikant L Mehta; Fang Gao-Smith; Tonny Veenith Journal: J Intensive Care Soc Date: 2020-09-03
Authors: D Mitra; B Gregson; V Jayakrishnan; A Gholkar; A Vincent; P White; P Mitchell Journal: AJNR Am J Neuroradiol Date: 2014-07-24 Impact factor: 3.825
Authors: Ana R Pereira; Paola Sanchez-Peña; Alessandra Biondi; Nader Sourour; Anne L Boch; Chantal Colonne; Lise Lejean; Lamine Abdennour; Louis Puybasset Journal: Neurocrit Care Date: 2007 Impact factor: 3.210