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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >White Matter Lesions as Brain Frailty and Age are Risk Factors for Surgical Clipping of Unruptured Intracranial Aneurysms in the Elderly
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White Matter Lesions as Brain Frailty and Age are Risk Factors for Surgical Clipping of Unruptured Intracranial Aneurysms in the Elderly

机译：白质病变作为脑体积脆弱和年龄是老年人悬垂颅内动脉瘤外科手术剪报的危险因素

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Introduction: We aimed to identify the risk factors for surgical treatment of unruptured intracranial aneurysms (UIAs) in individuals aged >60 years, particularly focusing on white matter lesions (WMLs). Material and methods: We investigated a total of 214 patients with UIAs. The patient group comprised 53 males and 151 females with an average age of 68.2 years. UIA size ranged from 2.7 to 26 (mean: 7.3) mm. The primary endpoint of the study was patient prognosis evaluated at the time of discharge using the modified Rankin Scale. We examined the risk factors for poor outcome and WMLs using magnetic resonance imaging. Results: Poor outcome was observed in 23 (10.7%) patients. Significant correlations were observed between poor outcome and UIA size (P < 0.0001), UIAs located posteriorly (P = 0.0204), UIA thrombosis (P = 0.0002), and presence of WMLs (P < 0.0001) in univariate regression analysis. However, no significant correlations were noted between poor outcome and age (P = 0.1438). Multivariate logistic regression analyses showed significant correlations between poor outcome and UIA size (P < 0.0001), presence of WMLs (P = 0.001). Severe WMLs based on the Fazekas classification was correlated to age (P < 0.0001) and atherosclerosis (P = 0.0001). Severe WMLs were associated with ischemia (P < 0.001) and epilepsy (P = 0.0502) as well as length of hospitalization (P < 0.0001). Conclusion: Severe WMLs are risk factors for surgical treatment of UIAs in the elderly. Surgical indications must be considered and caution should be taken when managing patients with severe WMLs. (c) 2020 Elsevier Inc. All rights reserved.
机译：导言：我们旨在确定60岁以上未破裂颅内动脉瘤（UIA）外科治疗的风险因素，尤其是白质病变（WML）。材料和方法：我们调查了214例UIAs患者。患者组包括53名男性和151名女性，平均年龄为68.2岁。UIA大小在2.7到26（平均7.3）毫米之间。研究的主要终点是在出院时使用改良的Rankin量表评估患者预后。我们使用磁共振成像检查了不良预后和WML的风险因素。结果：23例（10.7%）患者预后不良。在单变量回归分析中，观察到不良预后与UIA大小（P<0.0001）、UIA位于后方（P=0.0204）、UIA血栓形成（P=0.0002）和WML的存在（P<0.0001）之间存在显著相关性。然而，不良预后与年龄之间没有显著相关性（P=0.1438）。多变量逻辑回归分析显示，不良预后与UIA大小（P<0.0001）、WML的存在（P=0.001）显著相关。基于Fazekas分类的严重WML与年龄（P<0.0001）和动脉粥样硬化（P=0.0001）相关。严重WML与缺血（P<0.001）、癫痫（P=0.0502）以及住院时间（P<0.0001）有关。结论：严重WMLs是老年人UIAs外科治疗的危险因素。在治疗严重WML患者时，必须考虑手术适应症，并谨慎行事。（c） 2020爱思唯尔公司版权所有。

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