85 y male with disorientation Haemodynamically stable , came sleeping on stretcher but arousable and cooperative . ABC WNL . Disorientation since last 2 days progressive in nature . As per his wife he is more forgetful . He tripped and fell in bathroom two days back . Complained of headache at that time very mild in nature . No LOC / mid frontal headache complaints without radiation . This is worst headache he had in comparison to previous headaches he had in past . Known hypertensive / hypercholesterolemia . EKG / CXR done . Management ?

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Subdural hematoma . Can occur after minor head trauma in elderly patients and worsening mental status or even focal neurological complaints . There are many processes which can cause confusion in elderly - rapid assessment of blood glucose level EKG / and proper history is key steps to early management .

Completely agree with Dr. Neeraj one must file out SDH with this back ground.
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nsr LAD biphasic t in v4 v5 t inversion in v6 persistent s in v5v6....cxr normal...history is favorable of SDH /SAH which is progressive in nature...another possibility is hyponatremia which can be due to diuretcs given to treat htn....early CT brain is needed

CT Brain findings

Right Frontal lobe SAH? plz correct if I m wrong sir..
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CT brain case of cerebral concussion xray nad ECG lbbb ideal CT& mri brain known case of headache

CT s/o Case of SAH which causes sudden fall down due to giddiness.x ray n ECG are relatively normal. Neurosurgeon should intervene the case. U can give IV Mannitol and liq.glycerol The sensorium will improve for sure. Thanks

CT brain MRI is the best if available. d/d is subarachnoid hemorrhage or intrapatenchymal hemorrhage or any infection or sundial or extradural hematoma. lastly Alzheimer 's disease or any other dementia

look for electrolyte imbalance and sepsis..ask whether he had accidental fall or whether guidiness preceeded..

I agree with Dr Dhrupal about need of CT and to rule out SAH/SDH

if fever present rule out meningitis..

most common things to be considered first. 1 dementia 2 alzeimer's decrease 3 hyponatraemia 4 mri ....neurological conditions hence treatment accordingly. monitoring vitals . reassurance & physiotherapy.

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