Head Injury
Background
Symptoms and signs
Falls account for the majority of head injury cases in elderly. Serious head injuries are often a result of traffic accident. In the elderly, an apparently trivial head trauma may lead to complications not commonly seen in the young. Intracranial bleeding is the most worrisome complication. What’s more important to note is the onset of the intracranial bleeding may be delayed and may go unrecognized for months until the elderly suddenly deteriorates or becomes symptomatic.
It is usually not difficult to recognize the symptoms and signs of an acute head injury. There may be a wound or swelling on the scalp and the elderly may complain of pain. For those elderly who cannot express themselves properly, very often the injury is only incidentally noted. The elderly with acute complication as a result of the head injury almost always appear unwell and may appear different from their usual status. On the other hand, those with delayed complication are difficult to recognize. Sometimes, they may be able to recall that there was a head injury or the injury was so trivial that they forget it. One of the most well-known delayed complication in the elderly is called ‘subdural hematoma’. It means that there is blood collection beneath the dura covering the brain surface. The symptoms and signs are often subtle. For example, the elderly may appear more and more forgetful, with unexplained personality change or non-specific dizziness and headache. A high index of suspicion is needed.
Central Nervous System
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