Mom is 89 and fell and had surgery
 

My mom is 89 and she had a fall in July, 2013 and hit her head hard. She was driving a car , living alone, independent no problem before that fall. After a week was having right arm weakness and inability to say some words. On August 7 she had a burr hole surgery in left side of head. She has recovered quite well but has still some word hesitancy and dropping words and some memory, but not all the time. Still is shuffling when walking but doing outpatient therapy.Worse when tired. Right after the surgery, a CT showed no fluid. ,,,but on Sept 20 it showed hygroma.
They did a CT scan on Oct 4 and it said:
"There is stable prominance of cerebrospinal fluid space at the left frontal and parietal region again measuring 15mm in thickness. This is consistant with hygroma. The left sulci particularly at the vertex are smaller than on the right and this may represent some mass effect from the hygroma. No significant midline shift is seen."
An MRI of October 23 said:
"Stable moderate left frontal subacute to chronic subdural hematoma measuring 15 mm in maximum width with mild sulcal effacement in the left frontal lobe."
Is this something that HAS to be operated on again??? Mom is 89 and Im scared. Can this be watched to see if there is resorbtion???
How can it be followed??? They say that it will reabsorb over time. Anyone have any comments??

Hi and welcome to NT.

Sorry to hear about your mom. Not being a neurosurgeon I'm not qualified to say whether she needs surgery or not, but I’ll comment based on my experience, which included an epidural hematoma which did require craniotomy surgery.

To me, the key words from the 10/23 MRI are “stable” and “moderate”. No significant midline shift is a good thing.

At 89 there is enhanced risk in any surgery, so if the doctors feel that this would self-resolve and/or remain asymptomatic I would probably go that direction if it were me.

Best to you both.

:grouphug:

Thanks!! It helps to get your comments. Momhad surgery 3 months ago, so we are told it may be 6 months to a year to recover whatever she CAN recover. She is getting better but the speech thing is tha real problem right now. Did you have any speech problems or memory issues???
THANK YOU FOR THE HELP!!:D

I did. My neuropsycholgist noted "He does display aphasic disturbance as well as confusion and difficulties with attention and memory”, this about 4 weeks post injury.

At 8 weeks the aphasia had mostly cleared, but she reported "patient shows significant difficulties with visuospatial learning and recall, as well as mental flexibility and multitasking. He displays weaknesses in aspects of executive system functioning (retrieval of learned information, mental flexibility, abstract reasoning, problem solving, and verbal fluency).”

Fortunately these also cleared. Five months after the injury a full neuropsychological assessment report stated "On examination, the patient demonstrated intact cognition in all domains assessed including learning and memory, attention, processing speed, language skills and executive functions".

So healing can and does happen. Hopefully your mom can recover without further surgery. Sounds like a really strong and self-sufficient lady for being 89.

Thanks
 

Can I ask....did yu have followup MRIs during the months where you were thinking better? The neurosurgeon has mom on a small dose of steroid for 2 weeks...to see if it will remove any inflammation. The MRI she had a week ago showed 15mm of fluid but he wants to wait to see if it is reabsorbed. Does that seem reasonable???

I didn't have any follow up CTs or MRIs; the craniotomy surgery report stated that the evacuation of the hematoma was completed with no complications; I don't remember any of this but apparently there was a drainage tube placed for a day or so as a precaution but there were no complications that required follow up imaging.

15mm is actually quite a bit of fluid, but with no midline shift it sounds like something they want to see if it clears on its own.

From your experience...because I am trying to understand...HOW does the fluid reabsorb?? Just wondered how that happens... I know it DOES happen but it must take a long time...right?? Wonder what caused the additional fluid after the original surgery?? She disnt have another fall
THANKS again

Sorry, that one I can't really help answer; with the brain-blood barrier I'm not sure how the fluid would drain or be absorbed. Hers is a subdural hematoma (below the dura layer) where mine was epidual (above the dura) that was causing a midline shift (pushing the brain to one side of the skull). That probably needs to be a question for the neurosurgeon on your next visit unless one of the other posters know.