A 75 year old nursing home resident complains of headache, confusion and impaired vision for 4 days. She has multiple bruises on her head. What is the most likely cause of confusion in this patient?

The key is C. Subdural hematoma. [elderly patient with multiple bruises on her head suggest head

injury which can lead to subdural hematoma. Headache, confusion and impaired vision for 4 days

indicate subacute subdural hematoma (three pahges i) acute ii) subacute 3 – 7 days and iii) chronic 2 – 3

weeks]. Symptoms of subdural hematoma:

• a headache that keeps getting worse

• feeling and being sick

• confusion

• personality changes, such as being unusually aggressive or having rapid mood swings

• feeling drowsy and finding it difficult to keep your eyes open

• speech problems, such as slurred speech

• problems with your vision, such as double vision

• paralysis (loss of movement) on one side of the body

• problems walking and frequent falls

• seizures (fits)

• loss of consciousness

[Reference: nhs.uk]