Surgery for intracranial meningiomas in elderly patients

Ninety-three patients above 60 years of age underwent craniotomy for intracranial meningioma removal between 1980 and 1990 at the University Hospital Rotterdam. Sixty-four patients were 60-70 years of age, 29 were 70 years or older. Retrospectively, operative mortality, morbidity and outcome on discharge from hospital and at 6 months were assessed and correlated with age, sex, size and location of the tumor and preoperative neurological status. Seven patients (7.5%) had no or only minor symptoms, 68 (73%) had moderate neurological symptoms (able to live at home with some assistance) and 18 patients (19.5%) had severe symptoms and were dependent on assistance. Surgical mortality was 14%; after 6 months 17% of patients had died. Postoperative complications (surgical, medical or neurological) occurred in 41%. Neurological status 6 months after surgery was improved in 35 patients (38%), unchanged in 38 patients (41%) and worsened in 20 patients (21%), 16 of whom had died. Outcome on discharge from hospital and after 6 months correlated significantly with preoperative neurological status. There was no significant correlation with age, sex, size or location of the tumor. Removal of intracranial meningiomas in the elderly is associated with a high morbidity and mortality rate. However, a large number of elderly patients benefit from surgery for intracranial meningiomas, especially those patients with a good neurological preoperative status.