PROGNOSTIC IMPLICATIONS OF MENINGIOMAS IN THE ELDERLY (OVER 70 YEARS OLD) IN THE ERA OF MAGNETIC-RESONANCE-IMAGING

During the 5 years from 1987 to 1991, 89 elderly patients, aged 70 yea rs and over, were admitted to departments of neurosurgery in Yamaguchi prefecture with meningioma. The clinical features and prognostic impl ications of meningioma in the elderly were assessed retrospectively. S eventy-eight (88%) of the 89 patients underwent surgery, which was a h igher rate than has been previously reported. The length of clinical h istory was also shorter than in previous studies, and was partly due t o the recent introduction of magnetic resonance imaging (MRI). The inc idence of poor prognosis (severe disability, vegetative or dead) in th e elderly and a younger group aged less than 70 years was 13% and 7%, respectively, but the difference was not statistically significant. In the surgically treated elderly group, age did not influence the patie nt's outcome. The factors affecting the outcome were pre-operative neu rological deficit (p < 0.05), histological malignancy (p < 0.05), and multiple operations (p < 0.05). Twenty-seven of the elderly meningioma patients were in good physical condition with minimal neurological in volvement. They underwent total removal of the tumour at the first ope ration, and the histological diagnosis was benign. Twenty-five of thes e 27 patients fell into the best outcome category. Therefore, age alon e was not a factor preventing proper surgical treatment of meningioma in the elderly.