Background and Purpose Middle third parasagittal and falx meningiomas can cause severe neurological deficits. The incidence of meningioma rises with age and comorbidities. Elderly patients may suffer from operative complications and recover more slowly than younger patients. The aim of this study was to assess the clinical characteristics and surgery outcomes between younger and elderly patients with meningiomas. Methods The patients of middle third parasagittal and falcine meningiomas operated from January 2011 and December 2019 were reviewed in this retrospective study. All lesions arose from the middle third of the falx or superior sagittal sinus (SSS). The complications, such as peritumoral edema, operative blood loss, and neurological deficit, and postoperative hospital stay, were compared between groups. Results Forty-three elderly patients and 63 younger patients were included in the current study. The elderly had larger and more aggressive lesions than younger individuals (P=0.013). Moreover, the aging group had severe peritumoral edema (P=0.019) and longer postoperative hospital stay (P=0.009) than younger patients, while the younger suffered from higher blood loss (P=0.022) and reoperation (3 vs. 1) at perioperative period. Furthermore, no significant difference was detected in the neurological deficit between the two groups (p=0.97). Conclusions Although severe peritumoral edema gave rise to larger lesions, elderly patients with the middle third of parasagittal and falcine meningiomas shared similar surgery outcomes as younger individuals. However, after considering all the factors, elderly patients were more likely to develop minor postoperative complications compared to younger ones.
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