Two hundred and sixty-three consecutive head-injured patients aged ove
r 65 years, admitted to a neurosurgical service, are reported. In cont
rast to younger age soup the main cause was falls concomitant with a h
igh rate of cardiovascular pre-existing disorders. The distribution of
causes and grim results justify, in our opinion, regarding head injur
y in the elderly as a distinct entity requiring special surgical, medi
cal, organizational and ethical considerations.