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Falls are the leading cause of injury-related death for those 65 and older and can lead to other severe consequences, including broken bones and head injury.

PBGMC Neurosurgeon Richard Mendel, MD, takes falls seriously.  Many of his patients find their way to him as a direct result of a fall. "It doesn't have to be a majr traumatic incident. Unfortunately, in a senior, even a low-impact fall can result in a brain injury."

Why?

As we age, our brains begin to shrink. Our brain mass is fullest in our 20s and 30s, then we gradually begin to lose it. By the time we reach our 60s and 70s, our brain tissue is reduced and the subdural space, the space between our skull and brain, enlarges.  Veins are forced to travel over a wider distance from the skull to the brain, making them more vulnerable to tears and bleeding.

"When a person falls, it can cause a subdural hematoma, which occurs when a blood vessel tears and blood builds up in the space between the outer (dura) and middle layers of the covering of the brain (meninges)," Dr. Mendel says.

When To Get Help

If the injury is severe, you may need emergency surgery to drain the hematoma and control bleeding. However, in the case of small subdural hematomas, the blood may be slowly absorbed over several weeks or months, eliminating the need for surgery altogether.

"The key to a successful outcome is early intervention and the ability to diagnose and monitor the evolution of the injury," he says. A computerized tomography (CT) scan usually aids this process.

Symptoms of a hematoma include:

. Headache

. Episodes of confusion and drowsiness

. One-sided weakness or paralysis or difficulty walking

. Enlarged or assmmetric pupils or double vision

. Convulsions or loss of consciousness after head injury

. Nausea or vomiting

. Slurring of speech

. Weakness, numbness or tingling in arms or legs.

Contact a doctor immediately if you have these symptoms. Sometimes symptoms of a subdural hematoma can mimic other conditions such as strokes and brain tumors.  Therefore you should tell your doctor about any head injuries you may have suffered during recent months.

Medications that thin the blood increase your risk of bleeding following a fall. If you take blood thinners and experience a fall or a blow to the head, seek immediate medical attention.