The use of head computed tomography in elderly patients sustaining minor head trauma

Mack, Lisa R; Chan, S.B.; Silva, Julio C.; Hogan, Teresita M.

doi:10.1016/s0736-4679(02)00714-x

Cited by 85 publications

(27 citation statements)

References 37 publications

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“…A small subset of patients with mild TBI experience persistent symptoms, including posttraumatic headache, sleep disturbance, disorders of balance, cognitive impairment, fatigue, and mood disorders [95][96][97]. It is challenging to identify which patients are at high risk for prolonged postconcussive symptoms and long-term sequelae.…”

Section: Evidence and Recommendations For Follow-up Imaging In Tbimentioning

confidence: 99%

Imaging Evidence and Recommendations for Traumatic Brain Injury: Conventional Neuroimaging Techniques

Wintermark

Sanelli

Anzai

et al. 2015

Journal of the American College of Radiology

157

118

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Section: Evidence and Recommendations For Follow-up Imaging In Tbimentioning

confidence: 99%

Imaging Evidence and Recommendations for Traumatic Brain Injury: Conventional Neuroimaging Techniques

Wintermark

Sanelli

Anzai

et al. 2015

Journal of the American College of Radiology

157

118

View full text Add to dashboard Cite

“…It also is more susceptible to intracerebral, subarachnoid, and intraventricular hemorrhage because of fragile vessels and the effects of anticoagulant therapy (23,24) (Figs 1, 2). Even in cases of sig- nificant intracranial injury, geriatric patients are less likely to manifest neurologic signs of raised intracranial pressure because of brain atrophy, and geriatric patients with significant intracranial injury may not have hard neurologic signs (6,22,23).…”

Section: Head Injurymentioning

confidence: 99%

“…Rathlev et al (22) reported that 26% of geriatric patients presented with occult head trauma, with positive findings at CT but no altered consciousness, neurologic deficits, or clinical evidence of skull fracture, and 2.2% had significant intracranial occult injury that required procedural intervention or resulted in long-term disability. National guidelines currently recommend that all geriatric patients with minor head injury be evaluated with immediate head CT (6,23). There is greater likelihood that geriatric patients with head trauma will return to independent living if they are treated promptly (6,8).…”

Section: Head Injurymentioning

confidence: 99%

Geriatric Trauma: A Radiologist’s Guide to Imaging Trauma Patients Aged 65 Years and Older

Sadro¹,

Sandstrom²,

Verma³

et al. 2015

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Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures. Clinical evaluation of geriatric trauma patients is difficult because of overall frailty, comorbid illness, and medication effects. Specific attention should be focused on the effects of medications in this population, including anticoagulants, steroids, and bisphosphonates. Radiologists should use age-appropriate algorithms for radiography, computed tomography (CT), and magnetic resonance imaging of geriatric trauma patients and follow guidelines for intravenous contrast agent administration in elderly patients with impaired renal function. Because there is less concern about risk for cancer with use of ionizing radiation in this age group, CT is the primary imaging modality used in the setting of geriatric trauma. Clinical examples are provided from the authors' experience at a trauma center where geriatric patients who have sustained major and minor injuries are treated daily.

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“…Nevertheless, the criteria for clinical clearance of the cervical spine from the National Emergency X-Radiography Utilization Study (NEXUS) can be applied safely to these patients, with an expected reduction in cervical imaging comparable with that achieved in non-geriatric trauma patients [54]. Regarding the management of head injuries, especially because the combination of head injury and anticoagulation is associated with adverse outcomes after traumatic brain injury in elderly patients [55], head computed tomography (CT) on all elderly patients, even with minimal head trauma, and serial neurologic evaluation after the CT are recommended [8,56].…”

Section: Triage Of Elderly Trauma Patients and Trauma Team Activationmentioning

confidence: 99%

Polytrauma in the elderly: specific considerations and current concepts of management

Dimitriou

Calori

Giannoudis

2011

Eur J Trauma Emerg Surg

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With an aging and more active older population, an increased incidence of elderly trauma patients, including severely injured geriatric patients, is anticipated. Poorer functional outcomes and increased mortality and morbidity rates in these patients compared to their younger counterparts may be inevitable due to the associated pre-existing medical conditions and the reduced physiological reserves and compensatory mechanisms secondary to aging. However, mortality and complication rates can be reduced, and outcomes can be improved, when prompt and aggressive treatment is provided. Knowledge of the specific issues, challenges and the distinctive injury patterns of this unique trauma population is important when treating elderly polytrauma patients. In the herein study, the special needs of these patients and the current concepts on their management are summarised. Research in this field is ongoing in order to develop advanced management strategies to optimise outcomes. Overall, these patients should not be treated as "older adults", but as a special population with special considerations and the trauma care should be tailored to meet their specific needs.

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The use of head computed tomography in elderly patients sustaining minor head trauma

Cited by 85 publications

References 37 publications

Imaging Evidence and Recommendations for Traumatic Brain Injury: Conventional Neuroimaging Techniques

Imaging Evidence and Recommendations for Traumatic Brain Injury: Conventional Neuroimaging Techniques

Geriatric Trauma: A Radiologist’s Guide to Imaging Trauma Patients Aged 65 Years and Older

Polytrauma in the elderly: specific considerations and current concepts of management

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