Intracranial meningiomas in the elderly in the CT scan era

Intracranial meningiomas diagnosed and operated upon in similar five-year periods before and after CT scan are analysed. In the latter period the overall number of meningiomas and the average age of the patients have increased--tumours from 77 to 186, and average age from 50 to 56. All patients but one from the first group were operated on, while only 155 from the second group underwent surgery. Operation was rejected in 31 patients for different reasons. In the pre-CT scan epoch 25% of patients who were operated on were over 60 and 9% were over 65, whereas in the CT scan era these rates have risen to 35 and 21% respectively. Mortality and good recovery rate were the same in both groups up to 65 years of age. After 65, postoperative complications and mortality increased steeply: of the patients over 65 in whom the growth was excised 55% died. The radical surgery of intracranial meningiomas in geriatric patients over 65 still remains a tremendous challenge despite all the advances in operative technique, neuroanesthesia and intensive care. On these grounds, in such patients surgical indications should be carefully evaluated.