Introduction: Traumatic subarachnoid hemorrhage (tSAH) is associated to early cerebral contusion progression and its adverse prognostic seems to be independent of its association with age and other clinical factors.
We analyzed the impact of tSAH on elderly population with non-severe traumatic brain injury (TBI) on their outcome.
Methods: Data regarding non-severe TBI in patients older than 65, was collected from January 2008 to November 2012. Patients were classified depending on their admission computerized tomography (CT) scans in Group 1: tSAH and Group 2: tSAH associated to an intracranial lesion and/or skull fracture.
Results: Group 1: 59 patients, tSAH was located in the convexity in 36 patients affecting one sulcus. The thickness of the tSAH was more than 1 mm in 53 patients and all CT scans were classified as a Marshal II. There was no evidence of lesion progression or intracranial operations, one patient was admitted in UIC and none died.
Group 2: 56 patients, the tSAH thickness and CT classification was similar to group one, but a more diffuse distribution of the blood was observed. Subdural hematomas (SDH) and/or contusion were observed in 36 patients.
Nine patients were admitted in the UIC, three patients received a neurosurgical intervention and eight died as a consequence of the TBI.
Admission in UCI (p = 0,008), lesions progression (p =0) and deaths (p=0,001) were statistically different between both groups.
Conclusions: Traumatic SAH located on the convexity of one lobe with an initial CT scan classified as Marshall II did not represent a risk of lesion progression in patients over 65 with mild or moderate TBI, whether under anticoagulant/antiagregant therapy.
The distribution of the tSAH that was associated with other lesions was more diffusely. Patients in this group showed a higher mortality rate due to the lesions progression.
Patient Care: Our study would improve the detection of patients with a higher risk of neurological complications or mortality that may require neurosurgical treatment after non-severe TBI, in the elderly population.
Learning Objectives: Understand the risk of lesion progression after non-severe TBI in patients over 65 with tHSA.