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Review
. 2020 Aug;267(8):2469-2474.
doi: 10.1007/s00415-020-09854-9. Epub 2020 Apr 25.

The changing face of neurosurgery for the older person

Ellie Edlmann  1   2 , Peter C Whitfield  3
Affiliations
Review

The changing face of neurosurgery for the older person

Ellie Edlmann et al. J Neurol. 2020 Aug.

Abstract

Increased life expectancy and illness prevention and treatment have led to a growing population of older patients. These changes in patient population are apparent in neurosurgery; however, relatively little is reported about specific outcomes and prognostication in this group. This review summarises the challenges and management changes occurring in the treatment of three common neurosurgical pathologies; aneurysmal subarachnoid haemorrhage, head injury, and haemorrhagic stroke. A move towards less invasive neurosurgical techniques has implications on the risk-benefit profile of interventions. This creates the opportunity to intervene in older patients with greater co-morbidity, as long as improved outcomes can be evidenced. A critical part of assessing appropriateness for surgical intervention in older patients may be to change from a mindset of age to one of frailty and growing interest in scales assessing this may aid treatment decisions in the future.

Keywords: Elderly; Frailty; Neurosurgery; Subarachnoid haemorrhage; Trauma.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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