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Aneurysmal subarachnoid hemorrhage in the elderly : Helsinki experience 1980-2008

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Title: Aneurysmal subarachnoid hemorrhage in the elderly : Helsinki experience 1980-2008
Author(s): Supponen, Eljas
Contributor: University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine
Discipline: Neurosurgery
Language: English
Acceptance year: 2012
OBJECTIVE: The number of elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) is increasing but their prognosis remains unsatisfactory. Our aim is to determine which patients are most likely to benefit from active treatment. METHODS: Between 1980 and 2008, 289 patients aged ≥70 years were treated for aSAH at the Department of Neurosurgery, Helsinki University Central Hospital (HUCH). We assessed the functional outcome at three months and the mortality at one year after aSAH. RESULTS: Only 30% of actively treated patients had favorable outcome with a one year fatality rate of 36%. Predictive factors of favorable outcome included good initial clinical grade and the absence of intraventricular and intracerebral hemorrhage. Medical complications were associated with unfavorable outcome. CONCLUSION: Elderly aSAH patients have often poor prognosis. Severity of the SAH is the most important determinant of outcome. Active treatment decreases mortality and should be offered to patients with good initial clinical condition.

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