Clinical History | Neuroimaging | Neuropsychological Assessment | Summary
The GCS may be a less reliable measure of severity of injury
in older individuals because of numerous factors, including sensory deterioration
and preexisting dementia (Powers 2000). Moreover, because
many fall-related TBIs may be unwitnessed, the duration of time
before initial assessment may be more variable in this age group,
further limiting the utility of the GCS. As a result, additional history
must be obtained to clarify the extent of the insult and its effects
on the patient. Particularly important is the establishment of a preinjury
baseline. Age-related bias may lead clinicians to assume that post-TBI
cognitive deficits are merely reflective of a preexisting dementia.
In addition, previous brain injuries or cerebrovascular insults
may have occurred over the course of the individual's lifetime.