title: Advanced age as a contraindication to microvascular decompression for drug-resistant trigeminal neuralgia: evidence of prejudice?
abstract: Due to the alleged higher risk of complications of microvascular decompression for trigeminal neuralgia in elderly we evaluated its age-related results. A retrospective analysis of clinical outcome and complications was performed in 476 patients affected by drug-resistant trigeminal neuralgia who underwent microvascular decompression. As much as 117 patients older than 65 years (Group 1) and 359 under the age of 65 (Group 2) were followed-up for a period of 7-138 months. Pain relief was complete without medication in 84.5% in Group 1. Morbidity included slight trigeminal hypoesthesia in 5.8%; severe hearing loss in 0.9%; CSF leakage in 4.2%; transient diplopia in 3.4%; and posterior fossa subdural hematoma in 0.8% of these patients. Mortality was null. No statistically significant differences were observed between Groups 1 and 2. These findings seem to support the idea that microvascular decompression is not a dangerous surgical procedure in patients over the age of 65 years.
authors.affiliation: Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. ferrolipaolo@hotmail.com
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferroli
authors.forename: Francesco
authors.initials: F
authors.lastname: Acerbi
authors.forename: Massimo
authors.initials: M
authors.lastname: Tomei
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tringali
authors.forename: Angelo
authors.initials: A
authors.lastname: Franzini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Broggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000075202:Contraindications; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055806:Microvessels / Q000601:surgery*; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult