Head Trauma in Elderly Patients: Mechanisms of Injuries and CT Findings

Timler, Dariusz; Dworzyński, Michał J.; Szarpak, Łukasz; Gaszyńska, Ewelina; Dudek, Krzysztof; Gałązkowski, Robert

doi:10.17219/acem/27565

Cited by 18 publications

(16 citation statements)

References 12 publications

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“…Our mTBI-related intracranial lesion prevalence of 7.2% was consistent with recent studies performed in the elderly [9,13]. This lower prevalence found in EDs recent studies may have several causes.…”

Section: Discussionsupporting

confidence: 92%

“…Secondly, according to the mTBI definition of 1993, injury mechanisms were not only direct head strikes but also acceleration/deceleration movements without any direct external trauma of the head [14]. In accordance with literature our findings showed that ground-level fall was the most common cause of mTBI [1,13]. Therefore, the amount of mTBI kinetics involved in ground level fall in the elderly is less than in younger populations (ie: falls from over one meter or motor vehicle accidents).…”

Section: Discussionsupporting

confidence: 85%

“…In spite of the prospective nature of our study, it was not possible to determine the fall cause in more than one third of the cases. Timler et al showed in their retrospective study that the mTBI mechanism was not identified in 23.6% of the cases [13]. Furthermore, in our study, symptoms after mTBI were unknown in 13.5% of the cases.…”

Section: Discussioncontrasting

confidence: 51%

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Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Dubucs

Balen

Schmidt

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Mild traumatic brain injury is the leading cause of arrivals to emergency department due to trauma in the 65-year-old population and over. Recent studies conducted in ED suggested a low intracranial lesion prevalence. The objectives of this study were to assess the prevalence and risk factors of intracranial lesion in older patients admitted to emergency department for mild traumatic brain injury by reporting in the emergency department the precise anamnesis of injury and clinical findings. Methods: Patients of 65 years old and over admitted in emergency department were prospectively included in this monocentric study. The primary outcome was the prevalence of intracranial lesion threw neuroimaging. Results: Between January and June 2019, 365 patients were included and 66.8% were women. Mean age was 86.5 years old (SD = 8.5). Ground-level fall was the most common cause of mild traumatic brain injury and occurred in 335 patients (91.8%). Overall, 26 out of 365 (7.2%) patients had an intracranial lesion. Compared with cutaneous frontal impact (medium risk group), the relative risk of intracranial lesion was 2.54 (95% CI 1.20 to 5.42) for patients with temporoparietal or occipital impact (high risk group) and 0.12 (95% CI 0.01 to 0.93) for patients with facial impact or no cutaneous impact (low risk group). There was not statistical increase in risk of intracranial injury with patients receiving antiplatelets (RR = 1.43; 95% CI 0.68 to 2.99) or anticoagulants (RR = 0.98; 95% CI 0.45 to 2.14). Conclusion: Among patients of 65 years old and over, the prevalence of intracranial lesion after a mild traumatic brain injury was similar to the younger adult population. The cutaneous impact location on clinical examination at the emergency department may identify older patients with low, medium and high risk for intracranial lesion.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

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Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Dubucs

Balen

Schmidt

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…This finding is important because UFs are associated with significant intracranial injury 31 and are more likely due to syncope 32 or underlying cardiovascular disease. Our findings also demonstrate that baseline cardiovascular disease is also a significant predictor of UFs and investigation of these events requires a different stream of assessment, including heart rhythm monitoring and possibly carotid sinus massage.…”

Section: Discussionmentioning

confidence: 99%

Does baseline depression increase the risk of unexplained and accidental falls in a cohort of community‐dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA)

Briggs

Kennelly

Kenny

2017

Int J Geriat Psychiatry

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“…For those patients affected by osteoporosis, the risk of femoral fractures or vertebral body fractures is high, especially for ground-level falls or falls on stairs. The risk for head trauma is consistent across the whole elderly population, and such injuries may result in intracranial pathology with functional sequelae [15]. Progressive physical impairment can happen because of inactivity, which is recognized to be a factor in decreased body function in the elderly [16,17].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Physical Exercise on Balance and Prevention of Falls in Older People: A Systematic Review and Meta-Analysis

Papalia

Balzani

et al. 2020

JCM

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The aims of this systematic review and meta-analysis were to evaluate the effects of physical exercise on static and dynamic balance in the elderly population, and to analyze the number of falls and fallers. A systematic literature search was conducted using PubMed–Medline, Cochrane Central, and Google Scholar to select randomized clinical trials that analyzed the role of exercise on balance and fall rate in patients aged 65 or older. Sixteen articles were included in this review. Applying the Cochrane risk-of-bias tool, three studies were determined to be at low risk of bias, nine at unclear risk of bias, and four at high risk of bias. The meta-analysis showed improvements in dynamic balance (p = 0.008), static balance (p = 0.01), participants’ fear of falling (p = 0.10), balance confidence (p = 0.04), quality of life (p = 0.08), and physical performance (p = 0.30) in patients who underwent physical exercise compared to controls. The analysis of the total numbers of falls showed a decreased likelihood of falls in patients who participated in exercise programs (p = 0.0008). Finally, the number of patients who fell at least once was significantly reduced in the intervention group (p = 0.02). Physical exercise is an effective treatment to improve balance and reduce fall rates in the elderly.

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Head Trauma in Elderly Patients: Mechanisms of Injuries and CT Findings

Cited by 18 publications

References 12 publications

Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Cutaneous impact location: a new tool to predict intracranial lesion among the elderly with mild traumatic brain injury?

Does baseline depression increase the risk of unexplained and accidental falls in a cohort of community‐dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA)

The Effects of Physical Exercise on Balance and Prevention of Falls in Older People: A Systematic Review and Meta-Analysis

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