• Alessandro Riccardi, Roberto Lerza, Flavio Frumento, Grazia Guiddo, Maria Beatrice Spinola, Luca Corti, and Pierangela Minuto.
• S.C. Medicina e Chirurgia d'Accettazione e d'Urgenza-OBI, Ospedale San Paolo, Savona, 17100 Savona (SV), Italia. a.riccardi@asl2.liguria.it
• Am J Emerg Med. 2013 Jan 1;31(1):37-41.

IntroductionMild head injury (MHI) is a common clinical problem in emergency departments (EDs). Long-standing debate is still going on about MHI in the elderly: current guidelines recommend to perform a CT scan on this group.Materials And MethodsWe performed a retrospective study by reviewing patients older than 65 years, evaluated in our ED for which a CT scan of the head was performed for MHI, between 2004 and 2010. According to Italian Guidelines, we considered only patients with low-risk MHI.ResultsWe considered 2149 eligible patients: we recorded 47 pathological acute findings on CT scan (2.18%), but only 3 patients (0.14%) underwent neurosurgery. We analysed our patients according to different age groups: in patients in the 65- to 79-year-old group, we documented pathological findings on CT in 0.66% of cases, with a significant increase in the group older than 80 years, with a rate of 3.33% of acute findings on CT (OR 5.22, P < .001); 617 patients were on antiplatelet therapy: 22 of these patients (3.72%) had a pathological finding on CT scan (OR 2.23, P < .005).DiscussionOur retrospective analyses demonstrated that the incidence of intracranial complications after MHI is not different from that of the general population, and based on this finding, a CT does not seem to be necessary, at least up to 80 years old. Our data suggest that antiplatelet therapy could be a significant risk factor. Our results suggest that elderly patients between 65 and 79 years old without risk factors could be managed as younger patients.Copyright © 2013 Elsevier Inc. All rights reserved.

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