St. Emlyn´s - August 17, 2014 - by Richard Body
"The diagnosis and management of major trauma in the elderly is a really hot topic in Emergency Medicine right now. Compared to younger patients, the elderly can sustain much more serious injuries even with apparently trivial mechanisms. What’s more, they present very differently – and it’s easy to underestimate severity in this group at the time of initial presentation to the ED. For example, traumatic brain injury often presents with relatively subtle symptoms as there can be a lot more space in the cranial cavity due to cerebral atrophy. Subdural haemorrhage is common and identifying it can be tough. Even after diagnosis, there remains the question about whether neurosurgery stands to provide any benefit.
That’s why this paper really caught my eye. The authors aimed to derive a simple decision tool that could help to safely reduce referrals to neurosurgery for elderly patients with acute subdural haemorrhage – i.e. a tool that could tell us when a subdural needs surgery."
http://stemlynsblog.org/jc-when-a-subdural-needs-surgery-st-emlyns/