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Stephen J. Hentschel, Remi Nader, Dima Suki, Amer Dastgir, David L. Callender, and Franco DeMonte

T he elderly are one of the fastest growing population segments in the US. By the middle of this century, the number of persons 65 years of age and older will exceed the number of persons 0 to 14 years old, and in the year 2050 one of five persons in the US will be 65 years of age or older. 32 Advanced age may sometimes be considered a relative contraindication to aggressive resection of certain malignant tumors. This view is being challenged in the face of an elderly population that is healthier and can expect a mean of 17 additional years of life once the

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Raymond F. Sekula Jr., Edward M. Marchan, Lynn H. Fletcher, Kenneth F. Casey, and Peter J. Jannetta

elderly patients requiring treatment for TN in the US should increase substantially in the future. Despite reports that MVD for elderly patients with medically refractory TN above the ages of 65 and 70 years 2 , 8 has been shown to be both safe and efficacious, other “second-tier” treatments are frequently offered to elderly patients due to concerns of fitness for surgery. In an effort to add to the existing literature, we retrospectively analyzed our elderly population of patients to determine if microvascular decompression for trigeminal neuralgia in elderly

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François Proust, Emmanuel Gérardin, Stéphane Derrey, Sophie Lesvèque, Sylvio Ramos, Olivier Langlois, Eléonore Tollard, Jacques Bénichou, Philippe Chassagne, Erick Clavier, and Pierre Fréger

I mproved health and longer life expectancy have bearing on why a significant number of elderly patients are admitted to hospitals with SAH. From 9.1 per 100,000 for the global population, the annual incidence of SAH has been estimated to exceed 25 per 100,000 persons older than 70 years of age. 9 Currently, the majority of elderly individuals live independently in good mental health at their homes, and, despite the morbidity risk related to the aneurysm obliteration in this patient group with higher incidence of comorbidities, age does not constitute a

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Peter J. Wilson, Sacit B. Omay, Ashutosh Kacker, Vijay K. Anand, and Theodore H. Schwartz

T he number of people aged 70 years or over in the United States is projected to increase from 29.2 million in 2012 to 63.6 million in 2050. 30 In common surgical procedures, the majority of postsurgical deaths occur in patients 70 of age or older, 32 with even greater risks in those aged 80 years and above. 47 Whether this arbitrary age cutoff has the same negative prognostic correlation in benign intracranial pathology has not been clearly demonstrated. Pituitary tumors make up 12.9% of the primary intracranial neoplasms in the elderly, with an incidence of

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Lucas Bernardes Miranda, Ernest Braxton, Joseph Hobbs, and Matthew R. Quigley

C hronic subdural hematoma is a relatively common affliction, especially among the elderly in whom the incidence is estimated at 7.4/100,000. 4 The majority of the neurosurgical literature concerning this disease is devoted to various methods of acute treatment. Initially craniotomy was favored, but over time this has been supplanted by less invasive techniques of bur hole or twist-drill drainage. Although a recent review article, which summarized the data from 48 publications, indicted a modest average mortality rate of 2.8% and an 80% “cure” rate, the

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Jackson A. Gondim, João Paulo Almeida, Lucas Alverne F. de Albuquerque, Erika Gomes, Michele Schops, and Jose Italo Mota

studies. 7 , 8 , 21 , 23 , 24 As the population increases and becomes older, the proportion of elderly patients in whom pituitary adenoma (PA) is diagnosed must continue to rise. 34 Although elderly patients usually present a significant number of comorbidities and higher odds of postoperative complications when undergoing neurosurgical procedures, those with visual or neurological alterations or with symptoms secondary to hormonal dysfunction should be considered for surgical treatment. 21 , 24 Previous studies have analyzed the outcomes in elderly patients who

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Ethan A. Winkler, John K. Yue, Harjus Birk, Caitlin K. Robinson, Geoffrey T. Manley, Sanjay S. Dhall, and Phiroz E. Tarapore

T raumatic thoracolumbar fractures account for roughly 90% of all spinal fractures, 7 , 29 with an estimated 160,000 occurring annually in North America alone. 29 Across published reports, the annual fracture incidence ranges from 23 to 90 per 100,000 people, and the age distribution is bimodal, with the first peak being found in young adults between 15 and 29 years of age and the second peak in adults older than 65 years. 3 , 4 , 10 , 12 , 23–25 , 34 , 40 Factors that make the elderly more susceptible to these fractures include lower bone density, 20

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Matheus P. Pereira, Taemin Oh, Rushikesh S. Joshi, Alexander F. Haddad, Kaitlyn M. Pereira, Robert C. Osorio, Kevin C. Donohue, Zain Peeran, Sweta Sudhir, Saket Jain, Angad Beniwal, José Gurrola II, Ivan H. El-Sayed, Lewis S. Blevins Jr., Philip V. Theodosopoulos, Sandeep Kunwar, and Manish K. Aghi

projections show that the number of adults older than 65 years will more than double the number of children younger than 5 years and will account for a larger section of the worldwide population than adolescents and youth aged 15–24 years by 2050. 8 Elderly patients account for up to 14% of all patients diagnosed with pituitary tumors, with most lesions being NFPAs. 9–14 Although the incidence of PAs is higher in younger patients, the aging population renders investigation of the safety of surgical intervention for adenomas and other brain neoplasms crucial. Previous

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Carrie E. Andrews, Nikolaos Mouchtouris, Evan M. Fitchett, Fadi Al Saiegh, Michael J. Lang, Victor M. Romo, Nabeel Herial, Pascal Jabbour, Stavropoula I. Tjoumakaris, Robert H. Rosenwasser, and M. Reid Gooch

M echanical thrombectomy (MT) has tremendously extended the treatment window for acute ischemic stroke (AIS); however, evidence regarding the use of MT in elderly patients ≥ 80 years old remains incomplete. The randomized controlled trials that demonstrated the superiority of MT to medical therapy (MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND-IA) enrolled a limited number of patients ≥ 80 years old and were thus underpowered to examine the role of MT in this population. 11 The HERMES collaboration subsequently pooled data from these original trials to

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Lateral lumbar interbody fusion in the elderly: a 10-year experience

Presented at the 2018 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Nitin Agarwal, Andrew Faramand, Nima Alan, Zachary J. Tempel, D. Kojo Hamilton, David O. Okonkwo, and Adam S. Kanter

, elderly patients, often presenting with multiple medical comorbidities, are touted to be at an increased risk of peri- and postoperative complications. Minimally invasive spine surgery was first presented as an alternative to open surgery in 1991. 22 Lateral lumbar interbody fusion (LLIF) is a surgical technique that entails gaining access to the lumbar spine through a lateral approach by passing through the retroperitoneal fat and the psoas major muscle. 23 The main advantages of this approach include decreased intraoperative blood loss, lower intraoperative narcotic