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Dr. Andrew Rynne

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Suggest treatment for severe headache and vomiting in an elderly person

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5700 Questions

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Posted on Mon, 20 Mar 2017 in Brain and Spine
Question: Hi, My grandmother 85 yrs suffered from severe vomiting one episode with headache post which she developed lt side hemiplegia 10 days back & on CT the same day detected to have hematoma in the rt thalamus. She was immediately hospitalized, post which she has been started on IV mannitol tds & IV augmentin , antacid & brain stimulator tab..The second day on admission she has severe vomiting again, one episode, post which was shifted to ICU with the same treatment for observation and RT inserted .After 5 days she was in wards and still hospitalized. She has on & off has irrelevant talk & behavior , unable to receognise place & person .Vitals have been stable throughout .Yesterday a repeat CT has been done which shows 1 cm increase in the hematoma
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Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
Conservative and supportive treatment are sufficient at present.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your grandmother's clinical details. Based on this, she needs conservative management at this stage. This includes keeping the blood pressure under normal limits and providing adequate hydration and nutrition. Care is also needed to prevent clotting of blood in leg veins (deep vein thrombosis, DVT) and pneumonia.

We expect gradual recovery over several weeks with good physiotherapy.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar 18 hours later
Hi,

Have uploaded her CT reports on the day of admission and on the 10th day.
pls comment on the size of the hematoma .Seems to be worsened.
doctor
Answered by Dr. Sudhir Kumar 5 hours later
Brief Answer:
There is no significant change.

Detailed Answer:
Thank you for getting back.

I have noted the size of hematoma on both the CT scans. There is no significant change in the size of hematoma.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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