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My 87 YO Mother Began Losing Her Balance A Few
Question: My 87 YO mother began losing her balance a few days ago. Her condition is worsening by the day; she is now dragging her leg and says her hands do not seem to work as expected. Her speech is not clear. Until a few days ago she was an avid walker and worked around the house. She did fall a few weeks ago hitting her head. A recent CT shows no damage from the fall. She suffers from burning feet and hypothyroidism but treats the conditions with gabapentin and Synthroid respectively. She also treats high blood pressure and racing heart rate with Cartia XT.
My 87 YO mother began losing her balance a few days ago. Her condition is worsening by the day; she is now dragging her leg and says her hands do not seem to work as expected. Her speech is not clear. Until a few days ago she was an avid walker and worked around the house. She did fall a few weeks ago hitting her head. A recent CT shows no damage from the fall. She suffers from burning feet and hypothyroidism but treats the conditions with gabapentin and Synthroid respectively. She also treats high blood pressure and racing heart rate with Cartia XT.
Brief Answer:
She may've suffered an ischemic stroke or a dangerous SUBDURAL HEMATOMA
Detailed Answer:
Good evening.
In my opinion, your mother she be taken to a hospital right now. She has all thee signs and symptoms of a person who suffered a fall resulting in what is referred to as a SUBDURAL HEMATOMA which is causing pressure on the brain causing symptoms consistent with a stroke. The other possibility is that she may have suffered a spontaneous bleed intracranially which could be anywhere from the deep white matter or basal ganglia (since hands are not working well) to the cerebellum or brainstem although in the latter cases I would've expected for brainstem signs such as sudden and significant nausea/vomiting, with swallowing and choking difficulties.
The CT of the head may not be sensitive to a very small subdural hematoma at the time of the fall, which has not progressed and increased in size over the past few days to now cause the symptoms you are describing. The danger is that such a bleed (subdural) can be rather slow, quiet, but extremely dangerous since it may not stop bleeding that quickly (especially if she's on blood thinners of any sort) and continue to exert increasing amounts of pressure on the brain which if too great could result in herniation and severe complications, VERY severe complications. The other concerning feature of her history is that she has a "racing heart" which could be a description of something referred to as ATRIAL FIBRILLATION and so the risk of what be going on with that is that she threw an embolus from the left atrial appendage up north to the brain, brainstem, or cerebellum causing these symptoms.
For these reasons and based on the evolution of symptoms you are describing I am concerned for something intracranially that happened. She should have a neurological examination by a neurologist immediately, have another brain scan immediately to identify the problem (stroke vs. bleed) and be admitted for observation and appropriate intervention. She may also have metabolic issues going on as well as a urinary tract infection that could be causing some of the problems you're describing but again, the most dangerous thing that needs to be ruled out would be subacute stroke or intracranial bleed such as a SDH.
If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get your mother feeling back to normal as soon as possible.
This query required 33 minutes of professional time to research, assimilate, and respond in complete form.
She may've suffered an ischemic stroke or a dangerous SUBDURAL HEMATOMA
Detailed Answer:
Good evening.
In my opinion, your mother she be taken to a hospital right now. She has all thee signs and symptoms of a person who suffered a fall resulting in what is referred to as a SUBDURAL HEMATOMA which is causing pressure on the brain causing symptoms consistent with a stroke. The other possibility is that she may have suffered a spontaneous bleed intracranially which could be anywhere from the deep white matter or basal ganglia (since hands are not working well) to the cerebellum or brainstem although in the latter cases I would've expected for brainstem signs such as sudden and significant nausea/vomiting, with swallowing and choking difficulties.
The CT of the head may not be sensitive to a very small subdural hematoma at the time of the fall, which has not progressed and increased in size over the past few days to now cause the symptoms you are describing. The danger is that such a bleed (subdural) can be rather slow, quiet, but extremely dangerous since it may not stop bleeding that quickly (especially if she's on blood thinners of any sort) and continue to exert increasing amounts of pressure on the brain which if too great could result in herniation and severe complications, VERY severe complications. The other concerning feature of her history is that she has a "racing heart" which could be a description of something referred to as ATRIAL FIBRILLATION and so the risk of what be going on with that is that she threw an embolus from the left atrial appendage up north to the brain, brainstem, or cerebellum causing these symptoms.
For these reasons and based on the evolution of symptoms you are describing I am concerned for something intracranially that happened. She should have a neurological examination by a neurologist immediately, have another brain scan immediately to identify the problem (stroke vs. bleed) and be admitted for observation and appropriate intervention. She may also have metabolic issues going on as well as a urinary tract infection that could be causing some of the problems you're describing but again, the most dangerous thing that needs to be ruled out would be subacute stroke or intracranial bleed such as a SDH.
If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get your mother feeling back to normal as soon as possible.
This query required 33 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
She may've suffered an ischemic stroke or a dangerous SUBDURAL HEMATOMA
Detailed Answer:
Good evening.
In my opinion, your mother she be taken to a hospital right now. She has all thee signs and symptoms of a person who suffered a fall resulting in what is referred to as a SUBDURAL HEMATOMA which is causing pressure on the brain causing symptoms consistent with a stroke. The other possibility is that she may have suffered a spontaneous bleed intracranially which could be anywhere from the deep white matter or basal ganglia (since hands are not working well) to the cerebellum or brainstem although in the latter cases I would've expected for brainstem signs such as sudden and significant nausea/vomiting, with swallowing and choking difficulties.
The CT of the head may not be sensitive to a very small subdural hematoma at the time of the fall, which has not progressed and increased in size over the past few days to now cause the symptoms you are describing. The danger is that such a bleed (subdural) can be rather slow, quiet, but extremely dangerous since it may not stop bleeding that quickly (especially if she's on blood thinners of any sort) and continue to exert increasing amounts of pressure on the brain which if too great could result in herniation and severe complications, VERY severe complications. The other concerning feature of her history is that she has a "racing heart" which could be a description of something referred to as ATRIAL FIBRILLATION and so the risk of what be going on with that is that she threw an embolus from the left atrial appendage up north to the brain, brainstem, or cerebellum causing these symptoms.
For these reasons and based on the evolution of symptoms you are describing I am concerned for something intracranially that happened. She should have a neurological examination by a neurologist immediately, have another brain scan immediately to identify the problem (stroke vs. bleed) and be admitted for observation and appropriate intervention. She may also have metabolic issues going on as well as a urinary tract infection that could be causing some of the problems you're describing but again, the most dangerous thing that needs to be ruled out would be subacute stroke or intracranial bleed such as a SDH.
If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get your mother feeling back to normal as soon as possible.
This query required 33 minutes of professional time to research, assimilate, and respond in complete form.
She may've suffered an ischemic stroke or a dangerous SUBDURAL HEMATOMA
Detailed Answer:
Good evening.
In my opinion, your mother she be taken to a hospital right now. She has all thee signs and symptoms of a person who suffered a fall resulting in what is referred to as a SUBDURAL HEMATOMA which is causing pressure on the brain causing symptoms consistent with a stroke. The other possibility is that she may have suffered a spontaneous bleed intracranially which could be anywhere from the deep white matter or basal ganglia (since hands are not working well) to the cerebellum or brainstem although in the latter cases I would've expected for brainstem signs such as sudden and significant nausea/vomiting, with swallowing and choking difficulties.
The CT of the head may not be sensitive to a very small subdural hematoma at the time of the fall, which has not progressed and increased in size over the past few days to now cause the symptoms you are describing. The danger is that such a bleed (subdural) can be rather slow, quiet, but extremely dangerous since it may not stop bleeding that quickly (especially if she's on blood thinners of any sort) and continue to exert increasing amounts of pressure on the brain which if too great could result in herniation and severe complications, VERY severe complications. The other concerning feature of her history is that she has a "racing heart" which could be a description of something referred to as ATRIAL FIBRILLATION and so the risk of what be going on with that is that she threw an embolus from the left atrial appendage up north to the brain, brainstem, or cerebellum causing these symptoms.
For these reasons and based on the evolution of symptoms you are describing I am concerned for something intracranially that happened. She should have a neurological examination by a neurologist immediately, have another brain scan immediately to identify the problem (stroke vs. bleed) and be admitted for observation and appropriate intervention. She may also have metabolic issues going on as well as a urinary tract infection that could be causing some of the problems you're describing but again, the most dangerous thing that needs to be ruled out would be subacute stroke or intracranial bleed such as a SDH.
If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get your mother feeling back to normal as soon as possible.
This query required 33 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. The hospital diagnosed an ischemic stroke upon the third visit to the emergency department and admitted her to hospital. She is now stable and beginning physical and occupational therapy. We hope to see her discharged to a rehabilitation clinic soon. Again, thank you for your response.
Thank you for your response. The hospital diagnosed an ischemic stroke upon the third visit to the emergency department and admitted her to hospital. She is now stable and beginning physical and occupational therapy. We hope to see her discharged to a rehabilitation clinic soon. Again, thank you for your response.
Brief Answer:
So happy she is finally receiving more appropriate attention
Detailed Answer:
It is great news that your mother was felt to be appropriate (finally) for hospitalization, workup, and appropriate rehabilitative attention.
Do remember a couple of things about stroke that can make a difference in the future:
1. A person with possible symptoms of stroke stands a much better chance of being either diagnosed or cleared of suffering from a stroke if they are seen at a CERTIFIED STROKE CENTER that staffs neurologists and stroke specialists. The place of evaluation should be preferably associated with a SPECIALIZED CENTER for stroke care in the event that the patient requires immediate triage to a higher level of care or if there are any doubts as to what is going on and best management considerations. TIME IS BRAIN
2. If a person appears to be suffering from a stroke but an emergency room CT scan says that's not the case, I would ask the ER doc in charge if the neurologist was notified on the case and would they please consider calling the neurologist for an assessment.
3. MRI scans are infinitely more accurate and precise at identifying the presence of a stroke or not....even within the first few minutes after the event has begun evolving. CT scans are highly insensitive to smaller strokes in the early going, moderately sensitive if strokes are more evolved or larger in size, as well as not being very good as "seeing" strokes that lie in the POSTERIOR FOSSA (back of the brain). Again, one cannot say enough about how superb MRI scans are for this purpose....so don't be afraid of asking for the study and if necessary transferring the patient to a facility that is used to using MRI scans in order to distinguish between stroke and nonstroke.
4. Finally, TIME IS BRAIN and to that end check out this link to the site of the National Stroke Association where they have compiled Centers that are certified and amply qualified to take someone like your mother and recognize the earliest symptoms of a stroke so that it can be quickly acted upon....why? Because:
TIME IS BRAIN!
Once again, I am very happy to hear that your mother was given the relevant and necessary attention and I'm hopeful that she will be making improvements during the course of the next few weeks to few months.....Be patient, these things can take up to 18-24 or even 72 months.
Could you please do me the favor (if you have no further questions) of taking my comments on your Mom's case and critiquing them as you see fit. Hopefully, you'll be able to provide some encouraging words of feedback if you feel my analysis was helpful and made a difference to your mother getting the attention she needed. In addition I would greatly appreciate your closing the QUESTION with a 5 STAR rating and will also stay in touch with me within the next 1-2 months to give me some updates on your mom's neurological situation. You can find me at: www.bit.ly/drdariushsaghafi
This query required 30 minutes of professional time to research, assimilate, and respond in complete form.
Cheers!
So happy she is finally receiving more appropriate attention
Detailed Answer:
It is great news that your mother was felt to be appropriate (finally) for hospitalization, workup, and appropriate rehabilitative attention.
Do remember a couple of things about stroke that can make a difference in the future:
1. A person with possible symptoms of stroke stands a much better chance of being either diagnosed or cleared of suffering from a stroke if they are seen at a CERTIFIED STROKE CENTER that staffs neurologists and stroke specialists. The place of evaluation should be preferably associated with a SPECIALIZED CENTER for stroke care in the event that the patient requires immediate triage to a higher level of care or if there are any doubts as to what is going on and best management considerations. TIME IS BRAIN
2. If a person appears to be suffering from a stroke but an emergency room CT scan says that's not the case, I would ask the ER doc in charge if the neurologist was notified on the case and would they please consider calling the neurologist for an assessment.
3. MRI scans are infinitely more accurate and precise at identifying the presence of a stroke or not....even within the first few minutes after the event has begun evolving. CT scans are highly insensitive to smaller strokes in the early going, moderately sensitive if strokes are more evolved or larger in size, as well as not being very good as "seeing" strokes that lie in the POSTERIOR FOSSA (back of the brain). Again, one cannot say enough about how superb MRI scans are for this purpose....so don't be afraid of asking for the study and if necessary transferring the patient to a facility that is used to using MRI scans in order to distinguish between stroke and nonstroke.
4. Finally, TIME IS BRAIN and to that end check out this link to the site of the National Stroke Association where they have compiled Centers that are certified and amply qualified to take someone like your mother and recognize the earliest symptoms of a stroke so that it can be quickly acted upon....why? Because:
TIME IS BRAIN!
Once again, I am very happy to hear that your mother was given the relevant and necessary attention and I'm hopeful that she will be making improvements during the course of the next few weeks to few months.....Be patient, these things can take up to 18-24 or even 72 months.
Could you please do me the favor (if you have no further questions) of taking my comments on your Mom's case and critiquing them as you see fit. Hopefully, you'll be able to provide some encouraging words of feedback if you feel my analysis was helpful and made a difference to your mother getting the attention she needed. In addition I would greatly appreciate your closing the QUESTION with a 5 STAR rating and will also stay in touch with me within the next 1-2 months to give me some updates on your mom's neurological situation. You can find me at: www.bit.ly/drdariushsaghafi
This query required 30 minutes of professional time to research, assimilate, and respond in complete form.
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
So happy she is finally receiving more appropriate attention
Detailed Answer:
It is great news that your mother was felt to be appropriate (finally) for hospitalization, workup, and appropriate rehabilitative attention.
Do remember a couple of things about stroke that can make a difference in the future:
1. A person with possible symptoms of stroke stands a much better chance of being either diagnosed or cleared of suffering from a stroke if they are seen at a CERTIFIED STROKE CENTER that staffs neurologists and stroke specialists. The place of evaluation should be preferably associated with a SPECIALIZED CENTER for stroke care in the event that the patient requires immediate triage to a higher level of care or if there are any doubts as to what is going on and best management considerations. TIME IS BRAIN
2. If a person appears to be suffering from a stroke but an emergency room CT scan says that's not the case, I would ask the ER doc in charge if the neurologist was notified on the case and would they please consider calling the neurologist for an assessment.
3. MRI scans are infinitely more accurate and precise at identifying the presence of a stroke or not....even within the first few minutes after the event has begun evolving. CT scans are highly insensitive to smaller strokes in the early going, moderately sensitive if strokes are more evolved or larger in size, as well as not being very good as "seeing" strokes that lie in the POSTERIOR FOSSA (back of the brain). Again, one cannot say enough about how superb MRI scans are for this purpose....so don't be afraid of asking for the study and if necessary transferring the patient to a facility that is used to using MRI scans in order to distinguish between stroke and nonstroke.
4. Finally, TIME IS BRAIN and to that end check out this link to the site of the National Stroke Association where they have compiled Centers that are certified and amply qualified to take someone like your mother and recognize the earliest symptoms of a stroke so that it can be quickly acted upon....why? Because:
TIME IS BRAIN!
Once again, I am very happy to hear that your mother was given the relevant and necessary attention and I'm hopeful that she will be making improvements during the course of the next few weeks to few months.....Be patient, these things can take up to 18-24 or even 72 months.
Could you please do me the favor (if you have no further questions) of taking my comments on your Mom's case and critiquing them as you see fit. Hopefully, you'll be able to provide some encouraging words of feedback if you feel my analysis was helpful and made a difference to your mother getting the attention she needed. In addition I would greatly appreciate your closing the QUESTION with a 5 STAR rating and will also stay in touch with me within the next 1-2 months to give me some updates on your mom's neurological situation. You can find me at: www.bit.ly/drdariushsaghafi
This query required 30 minutes of professional time to research, assimilate, and respond in complete form.
Cheers!
So happy she is finally receiving more appropriate attention
Detailed Answer:
It is great news that your mother was felt to be appropriate (finally) for hospitalization, workup, and appropriate rehabilitative attention.
Do remember a couple of things about stroke that can make a difference in the future:
1. A person with possible symptoms of stroke stands a much better chance of being either diagnosed or cleared of suffering from a stroke if they are seen at a CERTIFIED STROKE CENTER that staffs neurologists and stroke specialists. The place of evaluation should be preferably associated with a SPECIALIZED CENTER for stroke care in the event that the patient requires immediate triage to a higher level of care or if there are any doubts as to what is going on and best management considerations. TIME IS BRAIN
2. If a person appears to be suffering from a stroke but an emergency room CT scan says that's not the case, I would ask the ER doc in charge if the neurologist was notified on the case and would they please consider calling the neurologist for an assessment.
3. MRI scans are infinitely more accurate and precise at identifying the presence of a stroke or not....even within the first few minutes after the event has begun evolving. CT scans are highly insensitive to smaller strokes in the early going, moderately sensitive if strokes are more evolved or larger in size, as well as not being very good as "seeing" strokes that lie in the POSTERIOR FOSSA (back of the brain). Again, one cannot say enough about how superb MRI scans are for this purpose....so don't be afraid of asking for the study and if necessary transferring the patient to a facility that is used to using MRI scans in order to distinguish between stroke and nonstroke.
4. Finally, TIME IS BRAIN and to that end check out this link to the site of the National Stroke Association where they have compiled Centers that are certified and amply qualified to take someone like your mother and recognize the earliest symptoms of a stroke so that it can be quickly acted upon....why? Because:
TIME IS BRAIN!
Once again, I am very happy to hear that your mother was given the relevant and necessary attention and I'm hopeful that she will be making improvements during the course of the next few weeks to few months.....Be patient, these things can take up to 18-24 or even 72 months.
Could you please do me the favor (if you have no further questions) of taking my comments on your Mom's case and critiquing them as you see fit. Hopefully, you'll be able to provide some encouraging words of feedback if you feel my analysis was helpful and made a difference to your mother getting the attention she needed. In addition I would greatly appreciate your closing the QUESTION with a 5 STAR rating and will also stay in touch with me within the next 1-2 months to give me some updates on your mom's neurological situation. You can find me at: www.bit.ly/drdariushsaghafi
This query required 30 minutes of professional time to research, assimilate, and respond in complete form.
Cheers!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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