What if you hit your head in a fall?

Friends who live in a retirement community tell us that, when residents fall, they are asked if they’ve hit their heads. If the answer is yes, they are taken to the hospital to be checked for possible brain injury. If the injury is severe, the person may have a life-threatening brain hemorrhage. But this is unlikely. If anything, the person might have a concussion. “Concussion” is another word for mild traumatic blunt injury.

My 97-year-old super-ager friend, Donna, who also lives in a retirement community, fell during a middle-of-the-night trip to the bathroom. As she was going down, she tried to fall like a 49er ("drop, roll, get up").  Nevertheless, she hit her head, but she did get up and went back to bed. The next morning she was dizzy and couldn't remember what had happened. After calling Resident Services, she was taken to the ER in an ambulance. She had a concussion.

Hitting your head can transmit a wave of pressure through the brain that can temporarily stun the neurons. Any damage to the brain caused by a concussion cannot be detected by a CAT scan or MRI. That’s because the damage occurs on a microscopic level. For this reason, a diagnosis is based on symptoms: headache, sensitivity to light, dizziness, nausea, vomiting, and amnesia. (With most concussions, there’s no loss of consciousness.) Such symptoms can last anywhere from seconds all the way up to weeks or even months. 

People who have had concussions may also experience memory problems, have trouble concentrating, suffer from drowsiness, and/or become irritable. For old people, concussion symptoms can be subtle and easily mistaken for normal aging.

Treatment for a concussion consists of rest, avoiding physical activities while recovering, and taking medicine for headaches. Donna says she "needed brain therapy." In fact, a series of therapists came to her apartment several times a week, helping her with movement and even speech. She felt "supremely supported and encouraged." She fell in early October. We met for lunch in late December. She says she's still concerned about loss of memory. To me, she seemed like her old self: alert, engaged, good humored, and energetic. She remembered how to get to the restaurant and directed me to it.

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