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Dr. Andrew Rynne

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What does an episode of severe vomiting and headache in an elderly person indicate?

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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Posted on Sat, 25 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. Neeraj Kumar 1 hour later
Brief Answer:
The improvement will be gradual

Detailed Answer:
Hello,
I have gone through your question and report and understand your concern.
The treatment for thalamic hemorrhage is right and needs to be continued.
The behavioral abnormalities may be due to electrolyte imbalance or involvement of thalamus itself.
The improvement will be gradual.
Drugs for agitation can be given like olanzapine or quitiapine.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Neeraj Kumar 24 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. Neeraj Kumar 18 hours later
Brief Answer:
Continue treatment under the treating physician

Detailed Answer:
Hello,
The increase in hemorrhage size is expected in first 24 hours and early CT doesn't pick the actual initial size.
The repeat CT is not showing any significant increase.
No signs of raised intracranial pressure.
If patient is clinically stable or improving then nothing to worry.
Gradual improvement is expected.
Wishing good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
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