Head Injury in Elderly: Risks and Symptoms After a Fall - Neurosurgery

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Head injuries in the elderly can be particularly concerning due to the increased risk of complications such as intracranial hemorrhage, especially after a fall. Your father's situation, given his age and medical history, warrants careful consideration.

Firstly, the immediate concern after a fall, especially one that results in a visible bump on the forehead, is the possibility of a concussion or more severe brain injury. The fact that your father experienced a sudden spike in blood pressure after the fall could be attributed to several factors. Stress and pain from the injury can lead to a temporary increase in blood pressure. Additionally, the body's response to trauma can trigger a fight-or-flight response, which also elevates blood pressure.
The presence of a large bump on the forehead suggests localized swelling, which is a common response to trauma. However, the development of dark circles around the eyes (periorbital ecchymosis) three days post-injury can indicate a more serious issue, such as a potential fracture of the skull or bleeding beneath the skin. This phenomenon, often referred to as "raccoon eyes," can be a sign of basal skull fractures or other intracranial injuries.
Given your father's history of low blood pressure and chemotherapy, which may have compromised his immune system and overall health, it is crucial to monitor his symptoms closely. The fact that he has not sought medical attention raises concerns, especially since he lives alone and may not have immediate access to help if his condition worsens.
In terms of symptoms to watch for, you should be vigilant for any signs of confusion, persistent headache, nausea or vomiting, seizures, or any changes in consciousness. These could indicate a more serious condition, such as a concussion or intracranial hemorrhage. If he experiences any of these symptoms, it would be imperative to seek medical attention immediately.

While it is understandable that you are concerned about the risks associated with visiting a hospital during the pandemic, the potential risks of not seeking medical care after a head injury can be far greater. If your father’s symptoms do not improve or worsen, it is advisable to arrange for a medical evaluation. This could include a CT scan to rule out any bleeding or other complications.

In summary, while the initial swelling and increase in blood pressure may be manageable, the appearance of dark circles and the potential for underlying injuries necessitate a thorough medical assessment. It is crucial to prioritize his health and safety, especially given his medical history and the risks associated with head injuries in the elderly. If he is unable to go to the hospital himself, consider arranging for transportation or seeking assistance from healthcare professionals who can evaluate his condition at home.