To evaluate the operative outcome and prognostic factors in patients over the age of 65 years who suffered from traumatic brain injury and surgical intervention.

Between January 2002 and December 2004, sixty one patients (41 males, 20 females) over the age of 65 years who had undergone surgical intervention of traumatic brain injury were retrospectively studied. Major preoperative clinical parameters such as mechanism of injury, Glasgow coma scale (GCS) score at admission, and pupillary reactivity and computed tomography (CT) findings were statistically analysed for prognostic significance.

Thirty-nine (63.9%) patients had poor outcome (26 deaths) and twenty-two (36.1%) had good outcome. Glasgow coma scale (GCS) score at admission, pupillary reactivity, and the presence of significant midline shift on CT scan had reached statistical significance in predicting outcome. Among the 26 cases of death, six (23.1%) die of pneumonia and one had sudden cardiac arrest.

Surgical outcome is unexceptionally poor in the elderly head-injured patients, especially in those patients who had GCS 8 or below, the presence of significant midline shift on CT scan, and unilaterally or bilaterally dilated pupil.