Neurotrauma: Geriatric neurotrauma
Traumatic brain injury is a world health burden. This chapter provides a detailed discussion about epidemiology, pathophysiology, and management of traumatic brain injury (TBI) specific to the geriatric population. The management of TBI in general is aimed at preservation of cerebral perfusion pressure, cerebral blood flow, and reduction in incidence and severity of secondary brain insults. However, no evidence-based national or international guidelines for management of geriatric neurotrauma exist. In order to reduce the risk of cerebral hypoperfusion, changes in cerebral physiology that occur with age warrant discussion. It is believed that with advancing age, there is shift to the right in cerebral perfusion pressure curve, as well as changes in cerebral arteriolar tone. Extensive evidence to support or refute the benefit of intracranial pressure monitoring in the elderly patient population is lacking. Geriatric trauma patients have a higher incidence of pulmonary and infectious complications postoperatively.