Concussion Education: A (Gentle) Knock on the Head For All of Us

Megyesi, Joseph F.

doi:10.1017/s0317167100015511

Cited by 2 publications

(1 citation statement)

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“…Awareness of the problem, through articles such as the one published here, is a start. Indeed, the seriousness of concussion in sport was somewhat ignored until research and journal publications helped to draw attention to the problem, with some of the important work being done here in Canada [11][12][13][14][15][16] . Now concussion is a mainstream topic with frequent newspaper articles and television reporting.…”

Section: Head Injury In the Elderly: Is Our Health Care System Ready mentioning

confidence: 99%

Head Injury in the Elderly: Is Our Health Care System Ready for the Fall(s)?

Megyesi¹

2014

Can. J. Neurol. Sci.

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2000 to 2011. There are a number of interesting findings in the article but perhaps the most important is that regression analysis showed a significant upward trend in the yearly number of TBI cases, (as well as an upward trending by year in the proportion of TBI cases), for patients aged 70 years or more. The trend was significant with the odds of being aged 70 or more and having a TBI increasing by about 9% each year. The authors also looked at the etiologies associated with TBI at their trauma centre. They found an upward trend in the proportion of falls from year to year, with about three times as many falls in 2011 compared to 2000. As well, regression analysis showed that length of hospital stay was significantly longer for older patients. There was also a significant association between mortality rate and trauma mechanism: interestingly mortality rate was highest for patients with falls (13.2%)-greater than for motor vehicle accidents (10.2%), work accidents (6.6%) and assaults (6.0%). The results of this article seem to fit reasonably well with a typical week of "on-call" for a neurosurgeon: now and then seeing a work related TBI patient on a weekday (as shown in the study), seeing one or more young male TBI patients on the weekend (sometimes due to a motor vehicle accident, sometimes due to an assault, usually in the summer ... as shown in the study) and seeing a fairly steady influx of elderly TBI patients who have fallen or otherwise sustained a blow to head prior to assessment in the emergency room (as shown in the study). Moreover, it is not unusual for these elderly patients to require admission for observation, or in some cases for surgical evacuation of a chronic (or subacute or acute) subdural hematoma. Often elderly patients can be a challenge to rehabilitate and prepare for discharge, resulting in prolonged hospital stays, as shown in the study. It is not unusual for the TBI to serve as means of bringing to attention the multiple medical problems that an elderly patient may have, further prolonging the stay. The appropriate disposition of elderly patients may prove a challenge as family members realize that their loved one may no THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES

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