Dr. Chang Geng of Keelung reminds: Elderly people who develop 7 symptoms including headache and drowsiness a few weeks after a fall should be alert to chronic subdural hematoma.

2026/09/26 07:30

Chen Pinyuan, director of the Department of Surgery and neurosurgeon at Keelung Chang Gung Memorial Hospital, reminds that if an elderly person gradually develops headaches, drowsiness, unsteady walking, etc. a few weeks after a fall, do not think it is just aging or a stroke; take a situational photo. (Picture taken from freepik)

[Health Channel/Comprehensive Report] An elder accidentally slipped at home and bumped his head slightly. It seems to be fine at the moment, so don’t be completely reassured. Chen Pinyuan, director of the Department of Surgery and neurosurgeon at Keelung Chang Gung Memorial Hospital, reminded that if an elderly person gradually develops 7 symptoms such as headache, drowsiness, slowed reaction, unsteady walking, or even unilateral weakness of hands and feet a few weeks after a fall, they should be alert. Don't just regard it as natural aging. Be careful because "chronic subdural hematoma" may be quietly growing in the brain.

Symptoms like dementia and stroke are easily ignored

Chen Pinyuan posted on Facebook that chronic subdural hematoma is a common type of bleeding in neurosurgery, but is most likely to be delayed in detection. Why is it so disguised? He explained that this is because its symptoms are very variable, including: headache, drowsiness, poor memory, slow reaction, slurred speech, unsteady gait and unilateral weakness, etc. Because it is too similar to dementia, stroke or simple aging, it is easily ignored by family members or even misdiagnosed. It is one of the few situations where "finding the real cause and dealing with it can usually improve significantly", so "thinking about it" itself is very important.

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A slight impact may cause blood to ooze slowly

Chen Pinyuan further explained that as we age, the brain will gradually shrink, the space between the brain and the skull will become larger, and the small bridging veins connecting the two will also be stretched tighter. At this time, as long as the head is subject to slight external force, or even just shaking, the blood vessels may be torn and blood will slowly ooze. Over 3 weeks, blood will gradually accumulate and compress the brain. Some elders may not even remember hitting their heads afterwards.

The most critical weeks to months after a fall

Chen Pinyuan emphasized that the biggest difference between chronic subdural hematoma and acute cerebral hemorrhage is the slow change. Weeks to months after a fall, family members should pay attention to whether the elder appears to be different from usual, such as becoming more sleepy, talking less, walking on one side or having difficulty holding things. These are important clues. If suspicion arises, CT of the head can often be quickly confirmed.

Medical police and anti-coagulant people need to be more careful about falling

Chen Pinyuan emphasized that in most chronic subdural hematomas, the accumulated blood and water can be drained out, and the symptoms can often be significantly improved within a few days, and there will be almost no trace on the head. With early detection and early treatment, the elders have a great chance to regain their original spirit and vitality. In addition, a special reminder is that the elderly who take anticoagulants are at higher risk and should pay more attention to preventing falls.