THE SURGICAL-MANAGEMENT OF BENIGN INTRACRANIAL MENINGIOMAS AND ACOUSTIC NEUROMAS IN PATIENTS 70 YEARS OF AGE AND OLDER

Over a 22-year-period (1967-1989) 80 patients 70 years of age and olde r underwent surgery for resection of a benign intracranial tumor. This group included 56 meningiomas and 24 acoustic neuromas. Forty-five of the tumors were completely excised, whereas 35 were partially removed . Tumor regrowth was documented in seven patients during the follow-up period, five of whom underwent additional surgery for resection of re current tumor. Thirty-six (64.3%) of the patients with meningiomas had only a minimal or no preoperative neurologic deficit, whereas twenty (35.7%) had a major deficit. Fifty-three (94.6%) patients who underwen t surgery for resection of their meningioma made a good recovery (48 w ere improved or unchanged and five had minimal nonincapacitating worse ning), one (1.8%) was worse, and two (3.6%) died. Fourteen (58.3%) of the patients with acoustic neuromas had only a minimal or no preoperat ive neurologic deficit, whereas 10 (41.7%) had a major deficit. Twenty -two (91.7%) of the patients who underwent surgery for resection of th eir acoustic neuroma made a good recovery (18 were improved or unchang ed and four had minimal nonincapacitating worsening), two (8.3%) were worse, and none died. We conclude that, when indicated, surgery for in tracranial meningiomas and schwannomas can be offered to patients 70 y ears of age and older with acceptable morbidity and mortality.