Neurosurgical management of the elderly patient

The records of 59 patients above the age of 65 operated on for diverse neurosurgical problems between January 1975 and September 1976 were reviewed. It was found that in only about half of the cases was the referral diagnosis correct. Most of the referred patients diagnosed as cerebrovascular accident or senile dementia were found to be suffering from intracranial space-occupying lesions or normal pressure hydrocephalus. Post-operatively there was a significant improvement in 48% of this group of geriatric patients, with no change in 23% and a poor result in 29%. When the data on patients with benign lesions were considered separately, it was found that in this group there was a significant improvement in 60%, with no change in 23% and a poor result in only 17%.