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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Prognosis For Subdural Hematoma?

My Father-in-law suffered a fall and suffered a Subdural heamatoma (blot Clot ) 3 1/2 months back. He was hospitalised in ICU for 15 days, and then brought home. He is a BP and Diabetic patient. However they are in good control. CT scan just a week ago shows the clot has been resolved. But my father-in- law canoot walk steadly at all, and needs 24 x 7 attention even now in his day to day activities.. He hallicinuates, gets deppressed often. He however eats quite well. He generally keeps sleeping. When awake he sometimes believes to be elsewhere than our home. He is pushing 94 years. His physician prescribed Serlift, and Admenta. That makes him all the more inert and very drowsy. Befor the fall he was in a very fit shape, inspite of his age, and performed all his activities very well. Today he can neither read the newspaper, or watch TV as he says he cant understand whats going on. What is the prognosis in such cases. ?
Tue, 31 Mar 2020
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Neurologist,  's  Response
Hi,

An important information that I need is: "Where is location of subdural hematoma?". Generally, we see the above symptoms when there is an insult is in the frontal lobe. Another point is "A resolved clot at CT scan does not change the prognosis". You should note that after a brain injury, there is only a 3-4 hours window to put off the pressure. After that the brain cells will be damaged and the damage will remain, even if the clot or the pathology resolves.

The other point is: As there is only 3.5 months since the insult, there is still hope for more improvement (at least for other 6 months). So, overall, you have still time for improvement, although the prognosis is worse in elder people. The two drugs that you mentioned seem to be good. I would suggest adding NeuroAid II to increase the chance of improvement.

Also, if a good occupational therapy center is available, I strongly suggest regular treatment sessions there, as rehabilitation is the only, evidence based treatment after brain injury due to subdural hematoma (if surgery not indicated). If occupational therapy is not feasible, or you cannot take him to the clinic, you can contact me or other neuro-rehab expert doctor to design an in-home exercise program for you.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Hooman Mahmoudi, Neurologist
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What Is The Prognosis For Subdural Hematoma?

Hi, An important information that I need is: Where is location of subdural hematoma? . Generally, we see the above symptoms when there is an insult is in the frontal lobe. Another point is A resolved clot at CT scan does not change the prognosis . You should note that after a brain injury, there is only a 3-4 hours window to put off the pressure. After that the brain cells will be damaged and the damage will remain, even if the clot or the pathology resolves. The other point is: As there is only 3.5 months since the insult, there is still hope for more improvement (at least for other 6 months). So, overall, you have still time for improvement, although the prognosis is worse in elder people. The two drugs that you mentioned seem to be good. I would suggest adding NeuroAid II to increase the chance of improvement. Also, if a good occupational therapy center is available, I strongly suggest regular treatment sessions there, as rehabilitation is the only, evidence based treatment after brain injury due to subdural hematoma (if surgery not indicated). If occupational therapy is not feasible, or you cannot take him to the clinic, you can contact me or other neuro-rehab expert doctor to design an in-home exercise program for you. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Hooman Mahmoudi, Neurologist