Results in the operative treatment of elderly patients with intracranial meningioma

With life expectancy in the industrial nations increasing during recent yea rs, the number of patients older than 70 years with intracranial tumours an d, especially, meningiomas is rising. To evaluate the indications for opera tive treatment, we reviewed 66 patients older than 70 years who were operat ed upon for intracranial meningioma in our department between 1991 and 1997 . The mean age was 75 years. The oldest patients were 86 years old. Thirtee n patients with recurrent meningiomas were operated upon. The mortality rat e was 7.6%. Neurological symptoms improved in 38 patients (57.6%), were unc hanged in 11 (16.6%), and deteriorated in 12 (18.2%). Patients with recurre nt meningiomas seem to have a higher operative risk and their outcome is wo rse than after a primary operation. In general, there were good postoperati ve results in patients with few concomitant diseases, small meningiomas, sm all edema, short time of operation, and accessible location (convexity rath er than skull base). Age in general is not a contraindication for operation . In cases of incidental findings of small meningiomas, we recommend observ ation and MRI follow-up. Symptomatic meningiomas should be removed whenever there is an acceptable risk from an internal or anaesthesiological point o f view.