[Clinical Characteristics of Talk and Deteriorate in Traumatic Brain Injury in the Elderly]

Recently, the incidence of traumatic brain injury(TBI)has been increased in elderly people. This study addresses the clinical characteristics of TBI in elderly people. The most frequent cause of TBI in elderly people is either falls on the ground or from heights since both motor and physiological functions are degraded such people. Acute subdural hematoma(ASDH)is the most frequent among acute traumatic intracranial lesions. Its high frequency could be possibly associated with increased volume of the subdural space resulting from atrophy of the brain in elderly people. Delayed aggravation of other intracranial hematomas have also been explained by such anatomical and physiological changes in elderly people. A recent study demonstrated that the survival rate of 2-6 days after TBI was significantly lower in the elderly people than younger adults, suggesting that "talk and deteriorate" may play an important role for the poor outcome in elderly people with TBI, although its mechanisms are not fully understood. Coagulopathy after TBI and pre-injury antithrombotic agents may be associated with such a delayed aggravation, making the management of TBI in elderly people in difficult. Establishing preventions and treatments for TBI in elderly people is urgent.