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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Dizziness, Falling And Pain While Peeing?

Doc,my dad had a fall and developed chronic leftsided frontoparital and occipital subdural collection and midline shift-7mm to the right.he is CRF and CAD,Patient aged 82. He is taking vinlep 300 , 3 tablets and veltamplus,zolfresh,heptoin-2 tablets as prescribed by physician. suddenly of late he develops dizziness and falling and huting him during urinating. he is in drugged stage. what went wrong.advise
Fri, 13 Feb 2015
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General & Family Physician 's  Response
Hi,
Sorry to hear about your dad. From what you said he has a chronic left-sided fronto-parieto-occipital subdural hematoma which has caused a mid-line shift of 7 mm. Ideally a 7 mm shift is an indication for surgical drainage of the hematoma collection, but understandably he couldn't have been a fit candidate for surgery. If he is now developing symptoms of inability to maintain balance and dizziness it might be due to progressive collection of fluid. In this case a bed side burrhole and evacuation can be done using a SEPS (subdural evacuation port system). Some of the symptoms you have described may also be present when the intracranial pressure increases and for this a bedside external ventricular drainage can be done. Please note though, that confirmation must first be done by doing an MRI and comparing it to the previous images and deciding if there has been an increase in the collection or if there are signs of enlargement of ventricles. I also noticed he has been on Zolfresh, which generally has to be avoided in the older people as it too can cause excessive drowsiness and stupor. But please discuss with your physician before stopping any medications.
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What Causes Dizziness, Falling And Pain While Peeing?

Hi, Sorry to hear about your dad. From what you said he has a chronic left-sided fronto-parieto-occipital subdural hematoma which has caused a mid-line shift of 7 mm. Ideally a 7 mm shift is an indication for surgical drainage of the hematoma collection, but understandably he couldn t have been a fit candidate for surgery. If he is now developing symptoms of inability to maintain balance and dizziness it might be due to progressive collection of fluid. In this case a bed side burrhole and evacuation can be done using a SEPS (subdural evacuation port system). Some of the symptoms you have described may also be present when the intracranial pressure increases and for this a bedside external ventricular drainage can be done. Please note though, that confirmation must first be done by doing an MRI and comparing it to the previous images and deciding if there has been an increase in the collection or if there are signs of enlargement of ventricles. I also noticed he has been on Zolfresh, which generally has to be avoided in the older people as it too can cause excessive drowsiness and stupor. But please discuss with your physician before stopping any medications.