Subdural Hematoma Recovers

My 57 year old husband with a history of heart disease (previously on Plavix) recently experienced a sycopial episode, fell and hit his head suffering an acute subdural hemmorhage. The neurosurgeon said there was some subarachnoid involvement but only a minor shift of less than 3 mm. It did not require surgery. After 3 days in the hospital he has returned home but does not seem to be recovering. He has a GCS of 14 and is occasionally slightly confused, he spends most of his day sleeping. His pain symptoms are difficult to discern because he has a history of chronic neck and shoulder pain and frequent headaches. His usual pain management routine, a combination of aspirin, Tylenol and caffeine is now unavailable secondary to the risk of bleeding so it is being managed (fairly ineffectively) with Percocet with tolerable improvement. He claims he is getting no sleep. His balance is slightly impaired, he is frequently dizzy and is experiencing vertigo and states he has difficulty hearing. He does not have an appointment for follow-up with his Neurosurgeon for a month. How concerned should I be? Shouldn't he be seen sooner than a month from now? Prior to his injury he was extremely active.
Thanks!

[caregiver222]

When there is a subdural hematoma, such as your husband suffered there is a "window of opportunity" to relieve the pressure from the brain by drilling small holes in the skull (this is a simple procedure and does not involve brain damage) plus protocols and medications to reduce swelling. It appears none of this was done.

I continue to be speechless when I hear of such stories, but my recent experiences in emergency rooms indicates we are still re-discovering the wheel and certifying people as physicians who lack an ability to "connect-the-dots". And their are emergency rooms that should have neon signs above the entrance that say: "abandon all hope, ye who enter here."

Having just gone through such an episode with a friend, and a brief argument with the triage nurse, who couldn't pour water out of a boot with directions on the heel, he recieved proper treatment.

If the window-of opportunity is missed the swelling impinges on blood flow and there is often irreversable damage to brain cells.

That being said, the brain has a great deal of redundancy and resiliency.

As fare as the neurolost "seeing him", if the swelling is not controlled with the "window", which was apparently not done, there is not very much to do except "watchful waiting" and prayer.

I would not give up hope, as these injuries take a long time to resolve themselves. Your husband needs plenty of hugging, support, physical therapy, exposure to new experiences, and love.

Don't give up on him.

The life-force is a magical entity.