The effect of age on outcome following severe head injury for patients in coma from the outset: A mitochondrial DNA degradation phenomenon?.

The effect of age on outcome following severe head injury for patients in coma from the outset: A mitochondrial DNA degradation phenomenon?.

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It is well known that the outcome from head injury click here is adversely affected by advancing age.The pathophysiological mechanisms behind this effect may be due to increased sensitivity to ischaemic brain damage associated with mitochondrial dysfunction seen both with advancing age and severe head injury.If that were the case, then all attempts at improving the outcome in elderly patients with severe head injury may be futile.

We set out to discover if our policy of maximum intervention for elderly patients with severe head injury would reverse this trend.Data from the Newcastle neurosurgery unit were collected prospectively from 1987 to 2000.There were 7,143 patients admitted during that period.

Outcome was assessed at 3 months by the 5 point Glasgow Outcome Score (GOS).There were 31 elderly patients admitted in coma (Glasgow Coma Sum (GCS) equal to or less than 8) between 1990 and 1995 and 40 similar patients between 1996 and 2000.Not one single patient of 70 years and above made a good recovery in either of these two periods.

One patient only in the second period of time was left with a moderate disability at 6 months.All 70 other patients were either severely disabled or grand love red heart reposado tequila died.(80% mortality).

The inability to withstand severe head injury (GCS equal to or less than 8) over 70 years of age might be programmed into our human mitochondria, which do not possess DNA repair processes.This phenomenon of mitochondrial DNA degeneration may render futile the treatment of these elderly patients with severe head injury.