Microvascular decompression for elderly patients with trigeminal neuralgia.

Area of Science:

• Neurosurgery
• Geriatric Medicine
• Neurology

Background:

• Microvascular decompression (MVD) is a primary treatment for trigeminal neuralgia (TN).
• The safety and efficacy of MVD in elderly patients with TN require further investigation.
• Elderly populations may have different risk profiles for surgical interventions.

Purpose of the Study:

• To compare the outcomes of MVD for TN in elderly versus younger patient populations.
• To assess potential differences in success rates, recurrence, and complication rates.
• To inform clinical decision-making for MVD in elderly TN patients.

Main Methods:

• Systematic literature review of six electronic databases.
• Inclusion of studies comparing MVD outcomes in elderly (≥60 years) versus younger TN patients.
• Analysis of outcomes including success, mortality, stroke, thromboembolism, meningitis, cranial nerve deficits, and CSF leaks.

Main Results:

• No significant difference in success rates between elderly (87.5%) and younger (84.8%) patients.
• Lower recurrence rates observed in the elderly cohort (11.9% vs. 15.6%).
• Higher rates of death (0.9% vs. 0.1%), stroke (2.5% vs. 1%), and thromboembolism (1.1% vs. 0%) in the elderly group.

Conclusions:

• MVD is an effective treatment for TN in the elderly, with comparable success and lower recurrence rates.
• Elderly patients undergoing MVD for TN have a significantly higher risk of mortality and major complications like stroke and thromboembolism.
• Risk-benefit assessment is crucial for considering MVD in elderly patients with trigeminal neuralgia.