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Neurosurgery in the elderly 

Neurosurgery in the elderly
Chapter:
Neurosurgery in the elderly
Author(s):

Chris Dodds

, Chandra M. Kumar

, and Frédérique Servin

DOI:
10.1093/med/9780198735571.003.0009
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date: 05 June 2020

The increasing provision of neurosurgery to the elderly is reviewed in this chapter. The two major areas of practice and the forms of presentation are briefly discussed. Specific issues with the elderly neurosurgical patient are then considered, including the urgency of the surgery, surgery duration, extent of the planned procedure, and management of concurrent drug therapy. Details on the common risks with hyperventilation and hypothermia are noted, and the use of more recent anaesthetic agents, remifentanil and desflurane, is covered. Spinal surgery for decompression and stabilization for cervical, odontoid, and lumbar regions, as well as the common risks and complications are discussed. Both vertebrectomy and vertebroplasty are reviewed. Intracranial surgery, usually for decompression because of tumour or haematoma, is discussed, including the recent aggressive treatment of haemorrhagic stroke. An overview of the developing field of stem cell implantation and stereotactic ablative surgery completes the chapter.

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