BACKGROUND: Generally accepted guidelines regarding the care of the elderly, anticoagulated minor head injury patient do not exist within the trauma literature. METHODS: Charts were reviewed on all anticoagulated, minor head injury patients older than 65 years between January 1993 and May 2000. Postinjury course was examined for neurologic changes, times, coagulation/radiographic studies, reversal, operative intervention, and outcome. RESULTS: Thirty-two patients were identified. Twenty-four patients were discharged from the Emergency Department. Three of the remaining eight patients had initial Glasgow Coma Scale scores of 15, 15, and 14 but became comatose over a mean course of 3.83 hours. A fourth patient presented comatose 6 hours postinjury, down from "acting normal." Three of these four patients died. CONCLUSION: Elderly, anticoagulated patients with minor head trauma risk neurologic deterioration within 6 hours of injury, despite an initially normal neurologic examination. Early cranial computed tomographic scanning and close observation for a minimum of 6 hours are indicated.
BACKGROUND: Generally accepted guidelines regarding the care of the elderly, anticoagulated minor head injurypatient do not exist within the trauma literature. METHODS: Charts were reviewed on all anticoagulated, minor head injurypatients older than 65 years between January 1993 and May 2000. Postinjury course was examined for neurologic changes, times, coagulation/radiographic studies, reversal, operative intervention, and outcome. RESULTS: Thirty-two patients were identified. Twenty-four patients were discharged from the Emergency Department. Three of the remaining eight patients had initial Glasgow Coma Scale scores of 15, 15, and 14 but became comatose over a mean course of 3.83 hours. A fourth patient presented comatose 6 hours postinjury, down from "acting normal." Three of these four patients died. CONCLUSION: Elderly, anticoagulated patients with minor head trauma risk neurologic deterioration within 6 hours of injury, despite an initially normal neurologic examination. Early cranial computed tomographic scanning and close observation for a minimum of 6 hours are indicated.
Authors: Daniel K Nishijima; Samuel Gaona; Trent Waechter; Ric Maloney; Troy Bair; Adam Blitz; Andrew R Elms; Roel D Farrales; Calvin Howard; James Montoya; Jeneita M Bell; Victor C Coronado; David E Sugerman; Dustin W Ballard; Kevin E Mackey; David R Vinson; James F Holmes Journal: Prehosp Emerg Care Date: 2016-09-16 Impact factor: 3.077
Authors: Daniel K Nishijima; Steven R Offerman; Dustin W Ballard; David R Vinson; Uli K Chettipally; Adina S Rauchwerger; Mary E Reed; James F Holmes Journal: Ann Emerg Med Date: 2012-06 Impact factor: 5.721
Authors: Erin B Wasserman; Manish N Shah; Courtney M C Jones; Jeremy T Cushman; Jeffrey M Caterino; Jeffrey J Bazarian; Suzanne M Gillespie; Julius D Cheng; Ann Dozier Journal: Prehosp Emerg Care Date: 2014-10-07 Impact factor: 3.077
Authors: Merelijne A Verschoof; Charlotte C M Zuurbier; Frank de Beer; Jonathan M Coutinho; Evert A Eggink; Björn M van Geel Journal: J Neurol Date: 2017-12-13 Impact factor: 4.849
Authors: Daniel K Nishijima; Steven R Offerman; Dustin W Ballard; David R Vinson; Uli K Chettipally; Adina S Rauchwerger; Mary E Reed; James F Holmes Journal: Acad Emerg Med Date: 2013-02 Impact factor: 3.451
Authors: Calvin H K Mak; Stephen K H Wong; George K Wong; Stephanie Ng; Kevin K W Wang; Ping Kuen Lam; Wai Sang Poon Journal: Curr Transl Geriatr Exp Gerontol Rep Date: 2012-07-06