The surgical management of benign intracranial meningiomas and acoustic neuromas in patients 70 years of age and older.

Over a 22-year-period (1967-1989) 80 patients 70 years of age and older underwent surgery for resection of a benign intracranial tumor. This group included 56 meningiomas and 24 acoustic neuromas. Forty-five of the tumors were completely excised, whereas 35 were partially removed. Tumor regrowth was documented in seven patients during the follow-up period, five of whom underwent additional surgery for resection of recurrent tumor. Thirty-six (64.3%) of the patients with meningiomas had only a minimal or no preoperative neurologic deficit, whereas twenty (35.7%) had a major deficit. Fifty-three (94.6%) patients who underwent surgery for resection of their meningioma made a good recovery (48 were improved or unchanged and five had minimal nonincapacitating worsening), one (1.8%) was worse, and two (3.6%) died. Fourteen (58.3%) of the patients with acoustic neuromas had only a minimal or no preoperative neurologic deficit, whereas 10 (41.7%) had a major deficit. Twenty-two (91.7%) of the patients who underwent surgery for resection of their acoustic neuroma made a good recovery (18 were improved or unchanged and four had minimal nonincapacitating worsening), two (8.3%) were worse, and none died. We conclude that, when indicated, surgery for intracranial meningiomas and schwannomas can be offered to patients 70 years of age and older with acceptable morbidity and mortality.