[A clinical study on head injuries in the aged].
We review 79 patients over 65 years old among 715 patients who underwent CT scans in the early period after head injuries, to study the characteristics of head injury in the aged. Among 79 aged patients, 24 developed posttraumatic subdural fluid collections, and in 13 of them chronic subdural hematomas developed subsequently. There were only three acute epidural hematomas. However, a high incidence of intracerebral lesions was noted, regardless of the presence of skull fracture. The pedestrian accident was the most frequent cause of head injury in the 36 aged patients admitted and the mortality rate of traffic accident in the aged was also highest. The relationship between Glasgow Coma Scale Score (GCS) on admission and the outcome was not parallel in the aged, because high GCS not rarely resulted in poor condition or death. Head injury is apt to occur and becomes severe in the aged pedestrian because of advancing carelessness and dull movements with age. The vulnerability of the brain to the injury and changes of intracranial environment in the aged tend to cause intracranial lesions much more than in the younger patients. Already-existing diseases and/or posttraumatic general complications also make clinical courses worse in the aged. It seems important for the improvement of the treatment that the characteristics described above are always taken into consideration throughout the period of the treatment in the aged, in order to eliminate worsening factors adequately. In addition, the social measures to cope with the suffering of the aged pedestrians from traffic accident should be considered and established in an aging society.
Ohno
K
K
Department of Neurosurgery, Tokyo Medical and Dental University, Japan.
Suzuki
R
R
Masaoka
H
H
Matsushima
Y
Y
Inaba
Y
Y
Monma
S
S
Asano
T
T
D000063:Accidents, Traffic; D000368:Aged; D001930:Brain Injuries / Q000150:complications; D002543:Cerebral Hemorrhage / Q000209:etiology; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D012887:Skull Fractures / Q000150:complications; D014057:Tomography, X-Ray Computed