Traumatic brain injury

Overview

Traumatic brain injury (TBI) is a common cause for emergency department presentation in the over 65yr age group. Falls are the leading cause for TBI presentations in older adults, with traffic and motor vehicle related trauma less common (51 vs 9%). (Thompson et al, 2006) Diagnosis of TBI is more challenging in this cohort, as demonstrated in one study 17% of older adults with TBI and a normal neurological examination were found to have an acute intracranial injury on CT brain. (Haydel et al, 2000) In addition, older adults with co-morbidities generally have a higher morbidity and mortality, with more complications and worse functional recovery than younger patients. (Gardner et al, 2018)

Anticoagulant therapy, in particular warfarin and the DOACs, pose additional challenges in this cohort with poor prognosis from neurocritical bleeding (50% mortality). (Cucchiara et al, 2008)

Description

This resource kit provides healthcare workers with the knowledge and skills for the assessment and management of traumatic brain injury in the geriatric population.

Learning objectives

• Perform a structured assessment and recognise severe traumatic brain injury (TBI).
• Implement neuroprotective management strategies and perform anticoagulant reversal.

Downloads

Further reading