Intracranial tumours in the elderly: the effect of age on the outcome of first time surgery for meningiomas.

We have investigated the effect of age on the outcome of first time surgery for intracranial meningiomas. In a retrospective study, 144 consecutive patients were divided into three groups: young (up to 44 years of age, 38 patients), middle-aged (45-64 years, 60 patients) and elderly (65 years and over, 46 patients). Outcome was assessed at the first follow-up appointment 4-6 months after discharge. The surgical mortality was 2.7%. The incidence of significant intercurrent disease increased with age (11, 25 and 35%, respectively), as did the incidence of postoperative complications (16, 23 and 30%). Postoperative intracranial bleeding was especially age-related, occurring in 20% of the elderly group as against 0% of the younger. Although the younger patients did best (100% in Glasgow Outcome Scale Grade 5) there was no difference in outcome between the middle-age and elderly groups (88 and 83%, respectively). Of the elderly patients, 89% showed clear functional improvement after surgery, 2% were unchanged and 9% were worse or dead. The intellectual deterioration apparent in over half of the elderly patients recovered after removal of the tumour in 80%. We conclude that age has little effect on the prospects of success after removal of an intracranial meningioma.