Characteristics of elderly fall patients with baseline mental status: high-risk features for intracranial injury

Prevalence and Severity of Traumatic Intracranial Hemorrhage in Older Adults with Low‐Energy Falls

“…Prior studies and meta‐analyses related to this topic demonstrated an association between tICHs and anticoagulation or antiplatelet agents in patients with head trauma . However, more recent studies did not demonstrate such an association, which is in line with our findings. However, due to different inclusion criteria of the studies, direct comparisons are difficult.…”

“…In cases of equivocal findings and treatment with anticoagulation or antiplatelet agents, application of clinical decision rules and guidelines prompts cCT examination. Based on our study and others, any visible injury sign above the clavicles was, in addition to cCT‐detected skull fractures, the strongest predictor for the presence of a tICH in older patients after a fall. Thus neither an unremarkable baseline GCS nor the absence of LOC or anticoagulation/antiplatelet therapy represents a safe criterion to omit a cCT in older patients with falls.…”

“…To date, specific recommendations are missing for low‐energy trauma in older patients such as ground‐level falls with or without anticoagulation or antiplatelet treatments and equivocal clinical signs of traumatic brain injury. Current studies on these particular patients are heterogeneous and bear some limitations, such as missing control group, small sample sizes, or lacking information about injury severity …”

Intracranial Hemorrhage in Older Adults: Implications for Fall Risk Assessment and Prevention

“…Some studies suggest that the incidence of ICH is more common and outcomes are worse when they occur in patients on anticoagulation . Others report that the incidence of ICH with anticoagulation is unchanged . These studies, in general, are limited as most are retrospective, have relatively low numbers of subjects, or have other methodologic limitations.…”

Massive subdural haematoma and dementia: a “yin and yang” paradigm

“…Axial and coronal non‐contrasted cerebral computed tomography images (Figure, A and B respectively) showed massive bi‐hemispheric acute (hyperdense) and chronic (hypodense) subdural haematoma, with extensive parenchymal compression. Dementia is strongly associated with brain atrophy and frequent falling, both of which are risk factors for subdural bleeding 1 caused by stretching and tearing of subdural veins 2 . The formation of a subdural haematoma can have further adverse effects in terms of cognitive decline.…”