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Suffered a head injury leading to sub dural hematoma. Treatment? - Online Doctor Chats

Date : 26-Mar-2013
User rating for this question
Very Good Posted in: Head Injuries
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1539 Questions
Doctor:Dr XXXXXXX here
User:My father in law suffered a head injury leading to sub dural hematoma on feb 11th 2012
User:he has been hospitalised since then
User:but the problem is that there is a continuous deterioration of his condition
Doctor:May I know his age ?
User:he is 77 he is unable to swaloow food since the last 2 weeks---being fed by a rice tube
User:he is constantly drowsy and does not even open his eyes unless he is shaken very vigourously
Doctor:Do you have the CT or MRI reports with you now ?
User:yes i do
Doctor:Can you please read it for me ?
Doctor:MRI would be useful
User:MRI of the brain was not done
User:a CT scan and a CT angiograph was done
User:subdural hemorrhage is seen along posterior interhenispheric fissure and along tentorium
User:small hemorrhagic contusion is seen in the right high frontal subcortical white matter
Doctor:Ok ,the above report confirms the presense of the bleed
Doctor:but cannot help to define progress
User:all ventricles are mildly dilated
User:what can be done--doctor says surgery is not an option for him
Doctor:A MRI scan can show what is the damage to the brain tissue which is the main indicator of progress or cure
Doctor:yes, he is right surgery will not be useful.. it is the healing of the damaged brain which is important for his survival
Doctor:keeping age into consideration the healing process is not expected to be optimum in him hence the progress cannot be predicted
Doctor:its just wait and watch process with some stabilizing medications
User:he has been like this for more than a month--from the fact that he is deteriorating --does it seem like its not healing at all?
Doctor:could be a chance
Doctor:since I do not know the extent of the damage i could not comment exact
User:is it advisable to bring him back home? he is in the ITU, can monitoring be done at home---you know family members get a feel that they can try and nurse him back to health
Doctor:Yes, but its clear decision of the treating doctors who know more about your father in law
Doctor:If they accept the defeat and cant gaurentee a recovery then you can go ahead with your decision
User:they are saying that there isnt much to be done--but they havent done any fresh scans/MRI since 20th february---and they are keeping in the hospital because of recurrent infections leading to an elevated total count
Doctor:infections are very common and mai
Doctor:* and one of the reasons for detriorating condition
Doctor:he has to be managed for them
User:can infections be managed at home---last week he had developed meningitis and pneumonia which subsided after antibiotics were given but total count has shooted up again and now a different antibiotic has been started. previously he was on moropenem a very strong antibiotic also----he has APKD as well as a polycystic liver--can his body handle so much antibiotics
Doctor:Well there are antibiotics which are safer in kidney diseases.. the choice of antibiotics depends on many other factors which can be evaluated by the treating doctor
Doctor:If you plan to treat him in home and expect a cure , i would say that is impossible
User:i am very worried. do you think that a recovery is at all possible?
Doctor:As I said i could not comment as i do not know the exent of brain damage
Doctor:and it could be a tough thought for the treating doctors too
User:yes i do understand that. Thanks for your advice
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