Neurologic complications of the elderly with trauma

Traumatic injury to nervous system is a significant problem in older adults. In recent years, instances of neurotrauma in the elderly have been increasing. Falls are the leading cause of traumatic brain injury (TBI) for older adults (51%), and motor vehicle traffic crashes are the second cause (9%). Age has been proposed as one of the most reliable prognostic factors following TBI. Both survival and functional outcomes are significantly poorer in the elderly compared to the younger patients with TBI. Geriatric patients are also vulnerable to traumatic spinal cord injury (SCI). The predisposing factors include: 1) osteoporosis, osteopenia, and natural changes in bone quality that occur with aging; 2) increasing prevalence of developmental cervical spinal stenosis due to spondylosis; 3) increased propensity for traumatic, related injuries (that is, falls) due to loss of sensory mechanisms and medication effects; and 4) a higher rate of motor vehicle collisions per mile driven. Traumatic injury to peripheral nerves is also a significant cause of morbidity and disability today. Different types of extremity trauma can result in specific damage to particular nerves associated with that limb. Trauma could cause different type of brain injury including:Contusion,Epidural hematoma ,Subdural hematoma, traumatic subarachnoid hemorrhage (tSAH) ,Diffuse axonal injury. Acute complications of TBI include: Csf fistula, Carotid- cavernous fistula, Arterial dissection and vascular injuries, Cranial nerve injury and infection. Chronic complications of head trauma include: Postconcussion syndrome, posttraumatic epilepsy, posttraumatic hormone disturbances, post-traumatic communicating hydrocephalus, autonomic dysfunction syndrome, extrapyramidal and cerebellar disorders and psychosocial problems. Treatments of neurological complications of brain injury include rehabilitation for cognitive and motor deficits, pharmacological treatments for epilepsy and headache and surgical interventions for hydrocephalus.