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Internist
Internist, Doctor
Category: Neurology
Satisfied Customers: 1066
Experience:  MD,MBBS, Diplomate American Board of Internal Medicine
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Last Tuesday ( 10/11/16) my mother who is 87 had a serious

Customer Question

Last Tuesday ( 10/11/16) my mother who is 87 had a serious fall while doing physio therapy.
She lost consciousness for 90 seconds. She was rushed to the hospital where they did a CT Scan. They mentioned that she had Tiny blood ventricles and fissures. The bleed stopped the next day on a follow up CT. They said no more imaging was needed.
Since then she has had issues with her memory, she cannot tell what year it is, or that in case of emergency one should call 911. She doesn’t exactly remember where the bathroom in the hospital room is, or that I saw her earlier that day. What my phone number is, etc.. It is similar to my vary naïve assumption of what Alzheimer’s may look like.
This is nothing like what she is usually like. Before the fall she had perfectly reasonable memory, was walking at a nice pace with a cane, and was in general good health for a 87 year old lady with no serious medical conditions.
She can walk ok, but her memory is very effected.
I appreciate that there is no way of knowing what the final outcome would look like, but I guess my question is in your experience, we are currently 6 days post fall. Could the fall triger Alzheimer’s or Dementia? Or is this likely a temporary state on her way to improvement? In general, what is the likely range of outcomes and rough probabilities of them?
Thank you for your help.
I would like to have an idea of ranges of outcomes, and would appreciate any and all insights.
Another question I have is:
Would it be more wise to get her to her home to provide her with comforts shes used to, or to keep her at the hospital where she is more irritated, wants to go home?
Submitted: 9 months ago.
Category: Neurology
Expert:  Internist replied 9 months ago.

Hi there,
I am online and will be happy to answer all your questions.
thank you for your patience.

sorry to hear about your problem.

1. this is not alzheimer's dementia.

most common cause of acute onset memory impairment in hospitalized elderly patients , associated with agitation is called delirium and is due to some medical condition for which person is hospitalized. hypoxia, electorlyte abnormalities, are major causes of delirium. this usually improves once the condition improves. Delirium is a sudden and severe change in brain function that causes a person to appear confused, disoriented, or to have difficulties maintaining focus, thinking clearly, and remembering recent events, typically with a fluctuating course. A urinary tract infection or dehydration can cause delirium in certain people.

managment is mainly conservative if no treatable trigger for delirium is found

Making sure the person gets enough to eat and drink (or providing nutrition through an IV, if needed)

pain management , avoiding discomfort

Making hearing aids and eyeglasses available at the hospital if the patient uses these at home

Expert:  Internist replied 9 months ago.

another possibility would be vascular dementia. usually associated with some neurological deficits. like acute onset focal weakness in legs/ upper limbs. sensory disturbances.

Expert:  Internist replied 9 months ago.

subdural hematoma also causes acute worsening of memory. and chronic subdural hematoma also leads to dementia.

Expert:  Internist replied 9 months ago.

for Q 2. yes you should keep her hospitalized, meanwhile simulate the environment to her home for her comfort level. as i mentioned above. caretaker present with patient, taking care of her needs all the time.

Expert:  Internist replied 9 months ago.

please feel free to ask any questions you have

Expert:  Internist replied 9 months ago.

I am here to help you and I wish you best health,

if done for now, please leave positive rating above the chat box.

we only get credit for helping clients after positive feedback.

If you have any more questions, please feel free to ask anytime.

Expert:  Internist replied 9 months ago.

please let me know if you have any questions.

Customer: replied 9 months ago.
Thank you for your response. Id like to follow up to make sure i understand correctly.To clarify, There was deffinately a triggering event, and that was the fall.
So it is my understanding that that:
"subdural hematoma also causes acute worsening of memory. and chronic subdural hematoma also leads to dementia."
is most relevent cause. This is a first TBI incident she has ever had, so it is not chronic.
With this in consideration is her current memory loss likely to be short term or long term?
Can/ is it likely for dementia onset to be instantly trigered by the TBI?"subdural hematoma also causes acute worsening of memory." in those cases, how is it likely to play out?
Expert:  Internist replied 9 months ago.

yes, correct.

sorry for late response . was away.

please feel free to answer any questions you have.