J L Wofford1, W P Moran, T A Wilson, R Velez. 1. Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Abstract
OBJECTIVE: To compare presenting manifestations of meningioma in elderly patients with those in younger patients. DESIGN: Retrospective survey. SETTING: Tertiary care center. PATIENTS: All hospitalized adult patients with the primary diagnosis of meningioma over a 5-year period (n = 116). Nine patients with recurrence of a previously resected meningioma were excluded. Fifty-two percent (56/107) of patients were > or = 65 years of age. MEASUREMENTS: Presenting symptoms were classified as asymptomatic, focal, non-specific, or both focal and non-specific. Presenting neurologic signs on physical examination were classified as focal, non-focal, or normal. Duration of symptoms was classified as < or = 1 week, 1 week to 1 month, 1 to 6 months, and > 6 months. RESULTS: Older patients presented more commonly with confusion (32% vs 4%) and dystaxia (28% vs 10%) than younger patients and presented less commonly with headache (23% vs 49%) and visual changes (21% vs 43%). While 2% of patients were asymptomatic at presentation, the remainder had symptoms categorized as focal (38%), non-specific (26%), or both (34%). There was no significant difference between older and younger age groups in the proportions of patients having focal symptoms. Duration of symptoms for all patients was categorized as < or = 1 week (15%), 1 week to 1 month (16%), 1 to 6 months (23%), and > 6 months (44%). In general, older patients were diagnosed earlier than younger patients. The presence of focal neurologic signs was not significantly different between older and younger patients. CONCLUSIONS: Presenting manifestations of meningioma differ between older and younger adult patients, but focality of symptoms and signs is similar. In this case series, the duration of symptoms prior to diagnosis was shorter in older than in younger patients.
OBJECTIVE: To compare presenting manifestations of meningioma in elderly patients with those in younger patients. DESIGN: Retrospective survey. SETTING: Tertiary care center. PATIENTS: All hospitalized adult patients with the primary diagnosis of meningioma over a 5-year period (n = 116). Nine patients with recurrence of a previously resected meningioma were excluded. Fifty-two percent (56/107) of patients were > or = 65 years of age. MEASUREMENTS: Presenting symptoms were classified as asymptomatic, focal, non-specific, or both focal and non-specific. Presenting neurologic signs on physical examination were classified as focal, non-focal, or normal. Duration of symptoms was classified as < or = 1 week, 1 week to 1 month, 1 to 6 months, and > 6 months. RESULTS: Older patients presented more commonly with confusion (32% vs 4%) and dystaxia (28% vs 10%) than younger patients and presented less commonly with headache (23% vs 49%) and visual changes (21% vs 43%). While 2% of patients were asymptomatic at presentation, the remainder had symptoms categorized as focal (38%), non-specific (26%), or both (34%). There was no significant difference between older and younger age groups in the proportions of patients having focal symptoms. Duration of symptoms for all patients was categorized as < or = 1 week (15%), 1 week to 1 month (16%), 1 to 6 months (23%), and > 6 months (44%). In general, older patients were diagnosed earlier than younger patients. The presence of focal neurologic signs was not significantly different between older and younger patients. CONCLUSIONS: Presenting manifestations of meningioma differ between older and younger adult patients, but focality of symptoms and signs is similar. In this case series, the duration of symptoms prior to diagnosis was shorter in older than in younger patients.