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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Tiredness And Lethargy After Injury

Yes, my 94 year old Mom fell and hit her head about a week ago (she was reaching for light cord) her head hit her dresser and she had significant bump on her head. We monitored her upon drs advise and she seems ok except about three days ago the black and blue is now coming down her back of neck and sides ...although she seems ok she is a bit more lethargic and tired...she is on Coumadin 3mgs....should we still just keep eye on her? She has about 20 stairs to climb down for a Cat but dr didn't recommend
posted on Mon, 24 Nov 2014
Twitter Sun, 11 Jan 2015 Answered on
Twitter Mon, 12 Jan 2015 Last reviewed on
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Neurologist,  's  Response
I read your query and I understand your concern.

Elderly people are more prone to having hemorrhagic complications after head injury. In your mom's case that is even more so since she's taking Coumadin. Usually it is said that these post injury hemorrhages are present in the first 24 hours which is generally true, but in the elderly it is often the case that they might evolve more slowly, I have seen many cases of chronic subdural hematoma in the older population.
So since you say her mental status is changing, looking lethargic, I believe a CT scan is necessary to check for subdural hematoma. Whether to intervene with surgery or not in that advanced age taking anticoagulants is another matter, but at least you should know in order to stop the treatment with Coumadin which doesn't allow the blood to clot.

I hope to have been of help.
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Suggest Remedy For Tiredness And Lethargy After Injury

I read your query and I understand your concern. Elderly people are more prone to having hemorrhagic complications after head injury. In your mom s case that is even more so since she s taking Coumadin. Usually it is said that these post injury hemorrhages are present in the first 24 hours which is generally true, but in the elderly it is often the case that they might evolve more slowly, I have seen many cases of chronic subdural hematoma in the older population. So since you say her mental status is changing, looking lethargic, I believe a CT scan is necessary to check for subdural hematoma. Whether to intervene with surgery or not in that advanced age taking anticoagulants is another matter, but at least you should know in order to stop the treatment with Coumadin which doesn t allow the blood to clot. I hope to have been of help.