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MAFlatt Asked January 2019

Can a fall cause a traumatic brain injury even it the person didn’t hit their head?

My 97 year old mother fell the weekend after Thanksgiving. She fell straight down and sat down hard. She said she was ok but two days later her back was hurting terribly. X-rays showed a compression fracture of the first lumbar. She tried Tramadol but made her exceedingly drowsy so Tylenol 3 was tried but that seemed to cause more confusion. Fast forward to now. She can have nothing stronger than Tylenol arthritis. The drugs are out of her system but her mental status has declined dramatically over the last 6 weeks. She has gotten agitated and combative to the point of needing Ativan. She always sees rain and says it’s raining. She will ask the same questions three or four times. She has hallucinations and is always reaching for things that aren’t there. I’m at a loss. Before the first fall she only had age related memory loss but no diagnosis of dementia.

InMyShoes Jan 2019
I agree with golden23 about getting a concussion without hitting your head. 

I knew a woman who fell off a horse and landed on her tailbone. The force of the fall went up her spine to her head. She ended up with a TBI and needed to learn how to walk and talk again. 

You should take your mother to see her doctor and have a CT scan done. 

My father did fall and hit his head and was given a CT scan at the ER. Everything looked fine but less than a week later he was talking funny and not making any sense. At the ER he was given another CT scan which showed a subdural hematoma because he was on a blood thinner. They treated him as if he had a stroke. He also had dementia.

Llamalover47 Jan 2019
Like others, I'm going to ask ~ Do you think she may have suffered a stroke? Get her to her neurologist stat.

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Grandma1954 Jan 2019
Is it possible that she had a stroke?
And before I go further a fall like that would hurt me and I probably would not feel the full effects for a few days. (and by then I may have even forgotten that I fell!..I get bruises and for the life of me can not recall what I did)
If she did not have a scan of the brain there is no way to tell. And they may not even be able to tell if there was damage there before or if the damage is recent.
I would discuss the hallucinations with a Neurologist. Not sure if an eye exam would be helpful, she may or nay not cooperate.
And if she has Vascular Dementia the little strokes will do more and more damage and you will see steeper declines than you would see with other dementia's.

SandyRenner Jan 2019
Are you sure that her fall was not cause by a mild stroke? My mother collapsed in a store a few years ago, got up and thought she was fine. A few hours later she told the nurses at her AL facility about the fall, they had her checked out and found that she'd had a stroke. After that event she has had a steady decline in memory and emotional health.

jacobsonbob Jan 2019
It's also possible, consider her age of 97, that the dementia would have developed/become obvious anyway even without the fall. Or the fall may have simply accelerated what would have happened fairly soon otherwise.

CharK60 Jan 2019
Hello,
My 93 year old mother had a fall just as you described. She had had an “accident” and slipped in pee on the floor while getting a change of clothes. She was using her walker and also grabbed a doorknob on her way down and landed right on her butt.

She never allows me to help her up (afraid i will hurt myself in the process)so I got help quickly and we all had a good laugh about it that day after she assured us she was ok. She was fine all that evening as well.

The next day she refused to get up out of bed! She swore she was in too much pain: in her back, in her side, in her head, etc. She wanted to be left in bed and soil her diapers instead of using the toilet.

We could not understand what was going on!

After 3 days of this we finally had my son-in-law lift her straight up and put her in the car to ER.

At the hospital she was still vague about what or where it hurt, but they determined she was constipated! Like 2 1/2 weeks since she’d had a bm and who knows how long before that?!

They sent her home that night but she was back in 2 days and ended up being hospitalized over a week before she finally had a bm.

I routinely gave her stool softeners twice a day and assumed they were working. Shame on me, I guess, but she hadn’t told me she was having a problem. She was also taking Vicodin for peripheral neuropathy due to diabetes which was stopped right there and then.

Following her hospital stay she had in home physical therapy and got some tools to manage her bodily functions: a “poop” calendar to be exact.

She is now just a little more mobile, not much, but she is so very weak she often needs help getting up from her chair. She sits for too long of a time and her legs don’t work.

Yes, I’ve also noticed some mental decline. I don’t know if she just asks for help more often or if she’s really unable to do things for herself.

I do know the more I help her the less she’s moving the weaker she becomes. She knows she should at least stand up from her chair and straighten her legs out but she won’t do it and gets mad when I ask.

That all happened last April and the two of us are virtually housebound since then. I have to have someone sit with her to go to drs appts for myself these past 9 months. She is improving mentally somewhat but not physically.

(She also has a fracture in her back they weren’t sure if it was caused by the fall or not.) The general diagnoses was that being severely constipated affected her balance which contributed to her falling.

Charlotte

97yroldmom Jan 2019
Your mother may need more time to recover. Ask her dr for the prescription strength lidocaine patch for her back. It really helped my mom with a fracture. She could not take strong pain meds either. A hospital rehab used it for her but her insurance (at that time) would not cover it when she went home as it was approved for shingles. Therapy helped her enormously. Ask the doctor for that as well. I’m assuming your mom was not hospitalized. Otherwise she probably would have been sent to rehab.
Please do get the UTI test. That could be the root cause of it all. Has she had blood work since the fall? Possible dehydration.
My FIL had a head trauma that caused the hallucinations etc. it took months but he had a full recovery. His sodium was the hard part to get stable.
Let us know how she is doing.

golden23 Jan 2019
You can get a concussion without hitting your head. Sitting down hard could cause the brain to move within the skull which can cause TBI. I would record her symptoms and take her back to her doctor for an assessment.

The signs of a concussion may include: (from healthline,com)
memory problems
confusion
drowsiness or feeling sluggish
dizziness
double vision or blurred vision
headache
nausea or vomiting
sensitivity to light or noise
balance problems
slowed reaction to stimuli

Good luck and keep us updated.

Isthisrealyreal Jan 2019
Yep, what Shell said.

Shell38314 Jan 2019
Your mom should be check out for UTI, infection & maybe a CT. Call her Dr asap. I don't think what your seeing is from the fall if she didn't hit her head. She needs a blood work up and to be check for a UTI. Call her Dr and make sure he/she knows all of her medications she is taking.

Best of luck!

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