Question Title: concussions

My father is 70 and quite active, in very good shape, works out four or five times a week. About three months ago, his nose was shattered playing basketball and the doctor who fixed it said he had taken an extremely hard blow to the head. He bled a lot and had to have surgery to fix it. Since then, he occasionally (once a week or so) has incidents where he seems to blank out; he becomes confused, he's asked my mother where he is; as if he couldn't recognize his surroundings. I witnessed it once; he swallowed a lot and yawned repeatedly and didn't seem to have any sense of what was happening. It lasted about 3 minutes but he asked questions for a few more; things like "what are eating there?" even though he had seen food come. The episodes seem to be decreasing not only in duration but in terms of time between incidents.

He refuses to talk about it; I know Alzheimer's has come to his mind though he won't talk about it. It seems mostly likely to me that they come from the very hard impact when breaking his nose. Also part of his fear is that the idea of having an MRI has come up and he had one once and it was a profoundly unpleasant experience that he (though he won't admit it) desperately wants to avoid (he's tall and solidly built). I was hoping these symptoms might be typical in some way and I could use the answer as ammunition to convince him to deal with it.

Dear Mike:

Sorry to hear about your father. I think, now this is given that I haven't examined him nor seen the surgical reports, that your father needs to see a neurologist. A concussion should not give you episodic memory lapses or behavioral changes. Even thought they are decreasing in duration and frequency, I believe that he needs a full neurological going over. This may entail a MRI, but it might be needed. When you arrange such a visit, please take all the records and films with you so the neurologist can fully account for all that has happened together with the exam. Best of luck.

Sincerely,

CCF Neuro MD

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