Can it be possible for an advanced elderly person on a blood thinner to escape a chronic subdural hematoma after a hard hit to the head?

Well, I don’t know what really constitutes a “hard” hit to the head, but when my father at age 89 fell in the middle of the night (nobody witnessed it), the result was a “goose egg” hematoma (collection of blood) on his forehead (a bulging bruise), plus immediate neurological symptoms.

The hit to his head must have been pretty good because he was irrational, then exhibited perseveration (repeatedly asking if he had fallen, despite my mother answering affirmatively every time he asked).

Then the amnesia over the past two weeks was exhibited. The week prior he had had a knee replacement surgery, and he at times thought it had not yet occurred, then was asking if he’d had it.

In addition to advanced age and the neurological symptoms, my elderly father was also on the blood thinner Coumadin at the time.

So we have an ugly recipe for a chronic (and even subacute) subdural hematoma.

I was pretty sure he was going to eventually—weeks down the road—begin exhibiting symptoms of a chronic subdural hematoma, even though the CT scan a few hours later, and 12 hours after that, was normal.

So I was on edge for the next 90 days, and warned my father to limit his driving, in case a neurological symptom suddenly appeared while he was behind the wheel.

But amazingly, 90 days went by without a single neurological symptom.

How is it that an elderly person on a blood thinner who fell and hit his head never developed a chronic subdural hematoma? I asked this to Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.

Dr. Park explains, “It’s always better to be lucky than good.  The mechanism of injury is very important.  If the injury was just local and didn’t involve the sudden acceleration/deceleration, there may not be a breaking of veins and resulting in SDH.”

There is also the possibility that my father does not have the age related brain shrinkage (atrophy) that many elderly people have, which puts them at risk for a brain bleed.

Two ways to help stave off the so-called age related brain atrophy is to use the brain a lot (which he has always done) and exercise (he’s been doing upper body exercise for years and keeping busy with household projects).

Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. He’s skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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