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Traumatic Brain Injury in the Elderly

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Abstract

As a result of demographic change, traumatic brain injury (TBI) in the elderly population is a difficulty which will occur increasingly. A report on the epidemiology of TBI and its pathophysiology (e.g., diffuse axonal injury) will give insight in the development of brain damage following head trauma. Initial evaluation of trauma severity and monitoring of process can be performed via imaging (computed tomography, magnetic resonance imaging) and biomarker profiles (S100B). An association between TBI and neurodegenerative illness exists. Of importance here are the biomarkers amyloid beta (Aβ) and tau as well as the existence of the apolipoprotein E ε4 allele.

An important factor influencing the elderly patient’s outcome is anticoagulation respectively coagulation abnormalities, as they go along with higher risk of intracranial hemorrhage like subdural hematoma or intracerebral hemorrhage.

In the field of intensive care unit treatment following TBI, there are certain differences (e.g., hypotension, surgery/craniotomy, intracranial pressure monitoring) in patients aged 65 years and older that should be kept in mind. Furthermore, factors such as the Glasgow Coma Scale (GCS) score, pupillary dilatation, stress-induced hyperglycemia, anticoagulation, levels of atrial natriuretic peptide, and age itself exert influence on the elderly TBI patient’s outcome. The appropriate use of resources, surgical intervention, intensive care unit treatment, and neurorehabilitation will improve the functional and cognitive outcome of patients of older age.

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Authors and Affiliations

  1. Department of Neurosurgery, Friedrich-Alexander-University Erlangen-Nürnberg, Schwabachanlage 6, D-91054, Erlangen, Germany

    Verena Röckelein, Michael Buchfelder MD, PhD & Andrea Kleindienst MD, PhD

  2. Department of Neurosurgery, Klinikum Amberg, Amberg, Germany

    Andrea Kleindienst MD, PhD

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  1. Verena Röckelein
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  2. Michael Buchfelder MD, PhD
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  3. Andrea Kleindienst MD, PhD
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Correspondence to Andrea Kleindienst MD, PhD .

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  1. Department of Neurosurgery, University Hospital of Lyon, Lyon, France

    Moncef Berhouma

  2. Hôpital des Charpennes, Hospices civils de Lyon, Villeurbanne, France

    Pierre Krolak-Salmon

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Röckelein, V., Buchfelder, M., Kleindienst, A. (2017). Traumatic Brain Injury in the Elderly. In: Berhouma, M., Krolak-Salmon, P. (eds) Brain and Spine Surgery in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-319-40232-1_19

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  • DOI: https://doi.org/10.1007/978-3-319-40232-1_19

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