[Frequent neurosurgically treatable diseases in geriatric patients]

Geriatrics and neurosurgery have several points of contact, which require a close cooperation. In this context, diseases frequently affecting old people include chronic subdural hematomas, benign and malignant brain tumors, normal pressure hydrocephalus, spinal compression syndromes, spinal nerve root and peripheral nerve affections. In the case of absolute indications for surgery (e.g., symptomatic subdural hematoma, paraparesis or tetraparesis due to compression of the myelon), no alternative conservative treatment option is available to prevent death or irreversible damage. Such interventions should not be withheld from geriatric patients, as long as there is a realistic chance to prolong their lives with a satisfactory quality and if they truly wish this intervention. With respect to relative indications for surgery (e.g., pain without paresis as a consequence of an affection of a nerve root or a peripheral nerve), surgery should only be considered once all options for conservative therapy have been exhausted.