Saturday, 9 February 2019

Head injuries common among aging people

       
Panchkula, January 30: “With rise in average age that pushed population of elderly people upward, the problems of ill health, loneliness and lack of support are also on increase among aging people. What has been noted in this group is that trivial injury also causes mortality and morbidity.”

Dr. Gauri Joshi, Sr Consultant,Neurosurgery stated this while addressing a health talk at Alchemist Hospital today.

She said further that apart from limb and spinal fractures, head trauma is one of the common injuries due to falls. Unlike the high impact or collision road side accidents which occur in all the age groups, especially the young, head injury and its consequences occur in the old due to trivial falls.

Talking about causes of injuries Dr Joshi said that fall in washroom is common among ageing people. Due to frequent getting up in the night for urination, the chances of fall especially in the dark increases. Many of these patients are on medications for blood pressure, diabetes and heart ailments. Due to sudden rising from the bed, some may develop giddiness and fall. Sometimes these patients have decreased sensations in feet and neuropathy which increases the chance of head injury. Sometimes due to imbalance, some patients bang their head against a wall or a door.
They can also sustain injuries while riding two wheeler or pillion rider besides other regular causes of road side accidents and assault.
In head injury , apart from the common symptoms of headache, vomiting, injury marks, there can be other subtle symptoms like forgetfulness, memory loss, confusion and imbalance while walking. Consultation with a doctor needs to be done along with a CT scan if required. 

One of the commonest consequences of head trauma in the elderly is the development of chronic subdural hematoma. Reason: As age progresses, there is shrinkage of brain. The surface veins from the brain surface to the dural covering of the brain get taut and thin. They rupture following a trauma and a subdural hematoma develops. This is further accelerated by the fact that many of these patients are on blood thinners.

This typically develops two to four weeks later. This develops as a big clot on one or both sides of the brain. Patient may develop headache, vomiting, limb weakness two to three weeks later. CT scan or an MRI of the brain is done to diagnose this. Fantastic results are obtained after a minor surgery on these patients.

Talking about prevention and precautions she said that it is very important for the elderly to take a stock of their present situation. Just because they were doing things in their earlier age, there is no guarantee that they can do things with the same efficiency.

Use of two wheelers should be restricted in the late seventies and eighties. Washrooms should be absolutely dry. The flooring should be of even surfaces. Need to be careful in wet slippery areas. Need to be regular with the medications and medical checkups. Also be aware with the side effects. After a fall, need to consult a doctor, as blood thinners drugs can be modified. There should be a dim light in the room, in case of night visit for urination. They need to be advised regarding use of proper footwear, which again will be helpful in patients with diabetes. The care givers should be instructed and educated regarding the potential risks and symptoms. Need for regular exercises, socializing cannot be over emphasized. Care should be taken while performing pranayama, where problems are seen after forced and prolong breathing.

However trivial the injury may seem, it is prudent to take medical help. It’s better to avoid some of the major complications rather than treat them.

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