As the population ages, traumatic head injuries in older patients are an increasingly common presentation to emergency departments. It is not uncommon for these patients to be taking some form of anticoagulant or anti-platelet therapy, which may put this group of patients at greater risk for a poor outcome. The optimal treatment for acute traumatic Subdural Haemorrhage [SDH] in the elderly can be uncertain, as high levels of co-morbid disease or drugs such as anti-coagulant and anti-platelet therapies may render the risks of neurosurgery too high, while the benefits of neurosurgery may be negligible in patients with particularly severe injuries or poor premorbid quality of life. Conservative therapy may be an appropriate treatment option in selected cases. Knowledge of prognostic factors after SDH aids decisions on choice of optimal treatment. In elderly patients sustaining a traumatic subdural haemorrhage, warfarin use, the number of associated intra-cranial pathologies, ISS and degree of midline shift were found to be predictive of death. Stephen Edward Asha, Factors Associated With In-Hospital Death among Elderly Patients Sustaining a Traumatic Subdural Haemorrhage.
Last date updated on June, 2014