Outcome following head injuries in the aged.

An analysis of 420 patients 60 or more years of age showed that even very mild brain injuries may be dangerous for the aged. Only one third of 174 patients with cerebral contusion made a useful recovery; of the 101 patients with cerebral contusion unconscious for six hours or more, 78 died, and only 11 made a useful recovery. The outcome in patients with acute intracranial haematomas or depressed skull fractures was poor. Even the aged with brain injuries may benefit from an intensive effort at treatment. This effort should, however, be strictly limited in time. With the present means of treating brain injury it seems futile to use limited intensive treatment resources for an acute brain injury in a patient over 70 years of age who is unconscious on admission. In contrast to acute injuries, subacute and chronic subdural haematomas should be operated on promptly in spite of severe neurological impairment or advanced age.