{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:48:59Z","timestamp":1782899339464,"version":"3.54.5"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The aim of this study was to determine age-related differences in short-term (1-year) outcomes in patients with unruptured intracranial aneurysms (UIAs).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Four thousand fifty-nine patients prospectively enrolled in the International Study of Unruptured Intracranial Aneurysms were categorized into 3 groups by age at enrollment: &lt; 50, 50\u201365, and &gt; 65 years old. Outcomes assessed at 1 year included aneurysm rupture rates, combined morbidity and mortality from aneurysm procedure or hemorrhage, and all-cause mortality. Periprocedural morbidity, in-hospital morbidity, and poor neurological outcome on discharge (Rankin scale score of 3 or greater) were assessed in surgically and endovascularly treated groups. Univariate and multivariate associations of each outcome with age were tested.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The risk of aneurysmal hemorrhage did not increase significantly with age. Procedural and in-hospital morbidity and mortality increased with age in patients treated with surgery, but remained relatively constant with increasing age with endovascular treatment. Poor neurological outcome from aneurysm- or procedure-related morbidity and mortality did not differ between management groups for patients 65 years old and younger, but was significantly higher in the surgical group for patients older than 65 years: 19.0% (95% confidence interval [CI] 13.9%\u201324.4%), compared with 8.0% (95% CI 2.3%\u201313.6%) in the endovascular group and 4.2% (95% CI 2.3%\u20136.2%) in the observation group. All-cause mortality increased steadily with increasing age, but differed between treatment groups only in patients &lt; 50 years of age, with the surgical group showing a survival advantage at 1 year.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Surgical treatment of UIAs appears to be safe, prevents 1-year hemorrhage, and may confer a survival benefit in patients &lt; 50 years of age. However, surgery poses a significant risk of morbidity and death in patients &gt; 65 years of age. Risk of endovascular treatment does not appear to increase with age. Risks and benefits of treatment in older patients should be carefully considered, and if treatment is deemed necessary for patients older than 65 years, endovascular treatment may be the best option.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.6.jns121179","type":"journal-article","created":{"date-parts":[[2014,8,29]],"date-time":"2014-08-29T14:07:44Z","timestamp":1409321264000},"page":"1024-1038","source":"Crossref","is-referenced-by-count":52,"title":["Age-related differences in unruptured intracranial aneurysms: 1-year outcomes"],"prefix":"10.3171","volume":"121","author":[{"given":"Kelly B.","family":"Mahaney","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa;\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Neurology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Meissner","sequence":"additional","affiliation":[{"name":"Departments of Neurology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Piepgras","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Huston","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns121179","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1161\/STROKEAHA.110.580647","article-title":"Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm","volume":"41","author":"Alshekhlee","year":"2010"},{"key":"b2-jns121179","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1227\/NEU.0b013e318207a9fb","article-title":"Treatment outcome of aneurysmal subarachnoid hemorrhage in patients aged 70 years and older","volume":"68","author":"Awe","year":"2011"},{"key":"b3-jns121179","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1227\/01.NEU.0000097195.48840.C4","article-title":"Age-dependent differences in short-term outcome after surgical or endovascular treatment of unruptured intracranial aneurysms in the United States, 1996\u20132000","volume":"54","author":"Barker","year":"2004"},{"key":"b4-jns121179","series-title":"Neuropsychiatr Neuropsychol Behav Neurol","first-page":"111","article-title":"The telephone interview for cognitive status","volume":"1","author":"Brandt","year":"1988"},{"key":"b5-jns121179","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1161\/STROKEAHA.110.607986","article-title":"Effect of age on outcomes of treatment of unruptured cerebral aneurysms: a study of the National Inpatient Sample 2001\u20132008","volume":"42","author":"Brinjikji","year":"2011"},{"key":"b6-jns121179","series-title":"J Psychiatr Res","first-page":"189","article-title":"\u201cMini-mental state.\u201d A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975"},{"key":"b7-jns121179","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1227\/01.NEU.0000367451.59090.D7","article-title":"Endovascular coiling of intracranial aneurysms in elderly patients: report of 205 treated aneurysms","volume":"66","author":"Gonzalez","year":"2010"},{"key":"b8-jns121179","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.3174\/ajnr.A2458","article-title":"Endovascular treatment for unruptured intracranial aneurysms in elderly patients: single-center report","volume":"32","author":"Hwang","year":"2011"},{"key":"b9-jns121179","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"953","DOI":"10.3174\/ajnr.A2881","article-title":"Age-related complications following endovascular treatment of unruptured intracranial aneurysms","volume":"33","author":"Khosla","year":"2012"},{"key":"b10-jns121179","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"410","DOI":"10.3171\/jns.1996.85.3.0410","article-title":"Age and outcome after aneurysmal subarachnoid hemorrhage: why do older patients fare worse?","volume":"85","author":"Lanzino","year":"1996"},{"key":"b11-jns121179","series-title":"Scott Med J","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1177\/003693305700200504","article-title":"Cerebral vascular accidents in patients over the age of 60. 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