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How to treat subdural haematoma

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Pixie-Rose

Registered User
Dec 10, 2010
7
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Hello, I need some advice as to how to move forward with a very difficult medical dilemma concerning my darling husband who has advanced alzheimer's. He is only 64 years old and was diagnosed 8 years ago.

In April this year my husband suffered a seizure (never having had one before) and then a month later he had another one. A CT scan was requested after the first seizure and we finally got an appt on 17th July!!!

The result was not good, an acute on chronic subdural haematoma. We were sent straight to A & E and I was told neurosurgeons at another hospital wanted to operate straight away but I had severe reservations because of the alzheimer's. After much deliberation with the medical staff who were wonderful, it was decided to admit my husband to monitor him for 4 days ( the length of time for aspirin to leave his system) hoping that stopping the aspirin would stop the bleed.

His first night in hospital was horrendous with him getting very upset and aggressive - understandably so as he was in an alien environment, a main ward in a bed with cot sides, all very frightening for him. I just managed to calm him down as the nurse was coming to give him an injection of valium.

Thankfully we got out after one night as my husband's neurological signs were stable (which shows he must be a tough cookie to still be functioning with this very serious problem!) and they could see he was unhappy in hospital.

It is now 2 weeks since the scan and we still have to face up to how to move forward with this live threatening condition.

I believe the neurosurgeons are still prepared to operate (2 burrholes into skull and a drain - apparently 3 days in hospital) but I still have grave reservations as to how my husband would cope with the anaesthetic and post operative recovery because of his alzheimer's - he has little or no speach and his comprehension is very poor most of the time. Is there anyone out there who has had a relative with advanced alzheimer's undergo surgery in hospital?

Apparently the drug Dexamethasone has been suggested by the neurosurgeon as a possible course of action - in the hope it helps shrink the clot. This to me seems the way to go however if it doesn't work we are still back to the operation dilemma.

Help, has anyone had to deal with similar problems ?

Thanks for listening

Pixie-Rose x
 

Grannie G

Volunteer Moderator
Apr 3, 2006
73,107
0
Kent
I can`t help you Pixie-Rose, I wish I could, but I just want to say how sorry I am for the nightmare you are living with and hope there is a successful outcome for your husband.
 

Butter

Registered User
Jan 19, 2012
6,737
0
NeverNeverLand
I am so sorry. I am sorry for you all. There are people on this website who have had to face these dilemmas - but the majority of them are with people who are older. However, they are not necessarily in better health from the point of view of AD.

At least you have confidence in the doctors.

There seems to be agreement that anaesthetic is not good. There seems to be agreement that hospital stays are not good.

My own husband has made it pretty clear he never wants to go into hospital again.

I wonder if you're able to rely on what your husband would do if your situations were reversed?
 
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lin1

Registered User
Jan 14, 2010
9,351
0
East Kent
Hi
Sorry to hear of your awful dilemma

Back in 2009 my dad somehow sustained a head injury
They found two sub dural haematomas
one was small
The other was larger but they said it was an old one :eek:

They also explained that they had been onto a big London hospital who I cannot name on here, who advised no action needed , the small one would sort itself and the old one was to old , which I thought strange.

They too kept dad in for 5 days for observation and to allow the Aspirin to get out of his system .

it did take my dad a long
time to recover and he did not recover fully
Though he is loads better

Dad can no longer have aspirin or ibuprofen
But since he was put on another drug to prevent his TIAs Clopidogrel dad has come on in leaps and bounds
Dad did not have dementia, so if it was
recommend he would have had the op

I cannot recommend whether or not the op would be best,
I know your very worried, I suggest you have a chat with his GP

Sending you a big ((((((HUG))))))
 
Last edited:

ITBookworm

Registered User
Oct 26, 2011
456
0
Glasgow
I can't comment on the haematoma but I can say a little about the burr hole. Hubby had to have one (for a pressure test prior to a totally different op) and that in itself wasn't particularly painful. It had a dressing on it afterwards was probably no worse than a cut from the discomfort point of view. I would say your main areas of concern would be the confusion of being in hospital at all, anaesthetic, and whether your husband could be relied on not to poke at/under dressings.

It might also be worth asking the doctor whether removal of the haematoma would give your husband a short term headache. If so that could be another problem since he wouldn't understand and wouldn't be able to communicate how bad it was/wasn't.

The 2nd operation my husband had did cause a very serious headache for a couple of days (even with serious painkillers!) :eek: and if that is at all likely I would NOT recommend it. Hubby knew exactly what was going on and could barely manage me holding his hand when visiting till the headache wore off enough a day or so later for the painkillers to totally work. Mixing that sort of headache with alzheimer's would be likely to seriously upset your husband.

I wish you both all the best with this horrible dilemma
 

Pixie-Rose

Registered User
Dec 10, 2010
7
0
I can`t help you Pixie-Rose, I wish I could, but I just want to say how sorry I am for the nightmare you are living with and hope there is a successful outcome for your husband.


Thank you, fingers crossed we will do the right thing
 

Pixie-Rose

Registered User
Dec 10, 2010
7
0
I am so sorry. I am sorry for you all. There are people on this website who have had to face these dilemmas - but the majority of them are with people who are older. However, they are not necessarily in better health from the point of view of AD.

At least you have confidence in the doctors.

There seems to be agreement that anaesthetic is not good. There seems to be agreement that hospital stays are not good.

My own husband has made it pretty clear he never wants to go into hospital again.

I wonder if you're able to rely on what your husband would do if your situations were reversed?

Thank you so much for your kind reply, fingers crossed we do the right thing.
 

Pixie-Rose

Registered User
Dec 10, 2010
7
0
Hi
Sorry to hear of your awful dilemma

Back in 2009 my dad somehow sustained a head injury
They found two sub dural haematomas
one was small
The other was larger but they said it was an old one :eek:

They also explained that they had been onto a big London hospital who I cannot name on here, who advised no action needed , the small one would sort itself and the old one was to old , which I thought strange.

They too kept dad in for 5 days for observation and to allow the Aspirin to get out of his system .

it did take my dad a long
time to recover and he did not recover fully
Though he is loads better

Dad can no longer have aspirin or ibuprofen
But since he was put on another drug to prevent his TIAs Clopidogrel dad has come on in leaps and bounds
Dad did not have dementia, so if it was
recommend he would have had the op

I cannot recommend whether or not the op would be best,
I know your very worried, I suggest you have a chat with his GP

Sending you a big ((((((HUG))))))

Glad your dad is loads better. We are discussing things with GP and community Psychiatrist but they never say exactly what they would do, the decision ultimately coming back to us. I think we are going down the Dexamethasone route to start with.
 

Pixie-Rose

Registered User
Dec 10, 2010
7
0
I can't comment on the haematoma but I can say a little about the burr hole. Hubby had to have one (for a pressure test prior to a totally different op) and that in itself wasn't particularly painful. It had a dressing on it afterwards was probably no worse than a cut from the discomfort point of view. I would say your main areas of concern would be the confusion of being in hospital at all, anaesthetic, and whether your husband could be relied on not to poke at/under dressings.

It might also be worth asking the doctor whether removal of the haematoma would give your husband a short term headache. If so that could be another problem since he wouldn't understand and wouldn't be able to communicate how bad it was/wasn't.

The 2nd operation my husband had did cause a very serious headache for a couple of days (even with serious painkillers!) :eek: and if that is at all likely I would NOT recommend it. Hubby knew exactly what was going on and could barely manage me holding his hand when visiting till the headache wore off enough a day or so later for the painkillers to totally work. Mixing that sort of headache with alzheimer's would be likely to seriously upset your husband.

I wish you both all the best with this horrible dilemma

Thank you, your point about interfering with the dressing is a good one especially as they would be leaving a drain in place and personally I do think he would interfere with it. Anyway for now it looks like we will be trying the Dexamethasone route in the hope it will shrink the clot.
Thanks again
Pixie-Rose
PS not sure if I am doing this right as I haven't submitted many things - apologies to all if I am not.
 

Noorza

Registered User
Jun 8, 2012
6,542
0
Thank you, your point about interfering with the dressing is a good one especially as they would be leaving a drain in place and personally I do think he would interfere with it. Anyway for now it looks like we will be trying the Dexamethasone route in the hope it will shrink the clot.
Thanks again
Pixie-Rose
PS not sure if I am doing this right as I haven't submitted many things - apologies to all if I am not.

Very difficult process for you. All I can say is if you rewound the clock 8 years and your husband could see himself as he is now, what would his decision be?
 
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