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Review
. 2020 Dec 21;15(4):809-820.
doi: 10.4103/ajns.AJNS_205_20. eCollection 2020 Oct-Dec.

Management of Mild Brain Trauma in the Elderly: Literature Review

Federica Marrone  1   2 , Luca Zavatto  1   2 , Mario Allevi  1   2 , Hambra Di Vitantonio  1 , Daniele Francesco Millimaggi  1 , Soheila Raysi Dehcordi  1 , Alessandro Ricci  1 , Graziano Taddei  1
Affiliations
Review

Management of Mild Brain Trauma in the Elderly: Literature Review

Federica Marrone et al. Asian J Neurosurg. .

Abstract

Purpose: The world population is aging. As direct consequence, geriatric trauma is increasing both in absolute number and in the proportion of annual admissions causing a challenge for the health-care system worldwide. The aim of this review is to delineate the specific and practice rules for the management of mild brain trauma in the elderly.

Methods: Systematic review of the last 15 years literature on mild traumatic brain injury (nTBI) in elderly patients.

Results: A total of 68 articles met all eligibility criteria and were selected for the systematic review. We collected 29% high-quality studies and 71% low-quality studies.

Conclusion: Clinical advices for a comprehensive management are provided. Current outcome data from mTBIs in the elderly show a condition that cannot be sustained in the future by families, society, and health-care systems. There is a strong need for more research on geriatric mild brain trauma addressed to prevent falls, to reduce the impact of polypharmacy, and to define specific management strategies.

Keywords: Brain trauma; elderly; head injury; head trauma; mild brain trauma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram for studies identification and selection process
Figure 2
Figure 2
Flowchart for management of mild traumatic brain injury in elderly patients. Co-injuries and anticoagulant therapy must be combined (GCS: Glasgow Coma Score; CT: Computed tomography; LoE: Level of evidence)
Figure 3
Figure 3
Flowchart for management of anticoagulant/antiplatelet therapy in mild traumatic brain injury elderly patients (ACs: Anticoagulants; APs: Antiplatelets; DOACs: Direct oral anticoagulants; INR: International normalized ratio; ICH: Intracranial hemorrhage; mTBI: Mild traumatic brain injury; CT: Computed tomography; LoE: Level of evidence)
See this image and copyright information in PMC

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