Meningiomas in the Elderly

Meningiomas can occur at any age, with incidence increasing as people age. Advanced imaging technologies and longer lifespans have led to the identification of numerous intracranial meningiomas (IM) in elderly patients. The primary surgical goal is to maximize tumor removal while minimizing harm and mortality. However, literature reports varying mortality and complication rates in elderly IM surgery patients. There is currently no consensus on the best surgical approach for elderly IM patients, and predictive factors for surgical outcomes remain unclear. This chapter explores factors impacting outcomes in elderly IM patients, reviewing clinical, radiological, biological, and surgical variables. Despite efforts to identify prognostic factors, data remain limited due to diverse study designs and surgical indications across neurosurgical centers, resulting in incomplete and conflicting information. New scoring systems may aid in determining optimal treatment, but surgical outcomes are more influenced by intraoperative challenges, available technology, and surgeon expertise. Managing IMs in elderly patients is challenging due to inconclusive surgical outcomes.