Clinical Features of Mild Head Injury in the Elderly

Young Bae Lee

doi:10.13004/jknts.2009.5.2.93

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Lee: Clinical Features of Mild Head Injury in the Elderly

Clinical Article

Journal of Korean Neurotraumatology Society 2009; 5(2): 93-98.

Published online: 31 December 2009

DOI: https://doi.org/10.13004/jknts.2009.5.2.93

Clinical Features of Mild Head Injury in the Elderly

Young Bae Lee, MD

Department of Neurosurgery, Gyeongju Hospital, Dongguk University College of Medine, Gyeongju, Korea.

Address for correspondence: Young Bae Lee, MD. Department of Neurosurgery, Gyeongju Hospital, Dongguk University College of Medine, 1090-1 Seokjang-dong, Gyeongju 780-350, Korea. Tel: +82-54-770-8230, Fax: +82-54-770-8378, leeyb@dongguk.ac.kr

Received 27 October 2009 Revised 27 October 2009 Accepted 3 November 2009

Abstract

Objective

In the case of mild head injuries, patients are generally expected to make a full recovery; however, for seniors, the prognosis is often less favorable. Therefore, this study will investigate clinical features and prognosis of mild head injury in patients who are 65 and older.

Methods

Between March 2006 to February 2008, a total of 76 elderly patients were admitted with a head injury and a Glasgow Coma Scale (GCS) score of between 13 and 15. Retrospective analysis was performed based on the patients' age, gender, cause of injury, medical history, CT diagnosis, GCS score at the time of admittance and clinical outcome.

Results

CT scan revealed abnormal findings in 38 cases (50%), and of those 12 cases showed acute subdural hematoma and 11 cases showed hemorrhagic contusion. When initial GCS scores and CT scans were examined, lower GCS scores were more likely to have abnormal CT scans, and this difference was statistically significant (p=0.005). When initial GCS scores and the patient outcome were examined, lower GCS scores correlated with adverse outcomes, and the difference was statistically significant (p=0.047).

Conclusion

Initial CT scans revealed abnormal findings in 50% of the patients, which demonstrates the need for a mandatory CT scans and follow up observations, even for elderly patients who initially do not display loss of consciousness. In addition, aggressive therapy is especially crucial in cases with abnormal initial CT findings to minimize morbidity and mortality in elderly patients.

Keywords: Elderly, Mild head injury, CT scan, Falling, Prognosis

Figures and Tables

TABLE 1

Summary of the patient's characteristics

GCS: Glasgow Coma Scale

TABLE 2

Initial CT findings

CT: computerized tomography

TABLE 3

Association between the CT scan findings and GCS score at the time of admission

p=0.005. CT: computerized tomography, GCS: Glasgow Coma Scale

TABLE 4

Analysis of delayed lesions detected with repeat CT scans

CT: computerized tomography

TABLE 5

Outcome at 6 months and GCS score in relation to the presence of CT abnormalities

GCS: Glasgow Coma Scale, CT: computerized tomography, GR: good recovery, MD: moderate disability, SD: severe disability, VS: vegetative state, D: death

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