A 40 year old chronic alcoholic who lives alone, brought in the emergency department having been found confused at home after a fall. He complains of a headache and gradually worsening confusion. What is the most likely diagnosis?

The key is D. Subdural hematoma. [subdural hematoma may be acute or chronic. In chronic

symptoms may not be apparent for several days or weeks. Symptoms of subdural hematomas are:

fluctuating level of consciousness, ± insidious physical or intellectual slowing, sleepiness, headache,

personality change and unsteadiness. Tx. Irrigation/evacuation e.g. via barr twist drill and barr hole

craniostomy 1st line. Craniotomy if the clot organized 2nd line].