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Head injury with subdural haematoma

Q: My mother suffered traumatic brain injury on 2 months back as a result of fall on platform. She is 59 years old housewife. She had a sub-dural haematoma and right sided hemiparesis. I would like to know if there is any advanced treatment other than physical therapy to recover leg movement. She sustained head injury following fall on the railway platform and became unconscious for a short while and regained her consciousness fully. There was no history of vomiting or seizure. She was admitted to a nursing home. The CT scan showed fracture of parietal bones with haemorrhagic contusions in the right temporal and bifrontal region with interhaemispheric sub-dural haematoma (SDH). She had a concomitant fracture in the left sided pubic ramus. She has developed right sided hemiparesis. She is mildly diabetic and hypersensitive. Her present condition has mild cognitive problem. Vision is OK and there is no cranial nerve signs. The motor power on the right side varies from 0/5 to 3/5. She is undergoing rehabilitation and physiotherapy and making some progress.

A:Your note shows that not only did your mother develop a subdural clot (collection of blood between the brain and its covering) but also suffered contusions to three different parts of the forebrain. I presume that the blood clot was not large enough to warrant removal by surgery. The physical damage done to the forebrain was quite severe. It is fortunate that she has recovered so well and now has residual weakness. This should improve under the care of your physician and physiotherapist. Your doctor is best able to tell you whether the improvement is likely to continue to normalcy or short of it. The fact that she continues to make progress is encouraging. There is no other advanced therapy. Much will depend on her own efforts by way of exercises and those of her physiotherapist and physician.

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