رجل عمره ٧٨ سنة عنده رجفان أذيني ويأخذ مميع دم، سقط في البيت قبل ٣ أسابيع وضرب رأسه ولم يراجع. الآن عنده صداع وتشوش يزيد ببطء ونسيان وضعف خفيف في يده اليسرى. الضغط ١٤٦/٨٤. ما الأرجح؟

A 78-year-old man with atrial fibrillation on an anticoagulant fell at home and hit his head 3 weeks ago without seeking care. He now has slowly worsening headache, confusion, forgetfulness and mild left hand weakness. BP 146/84. What is most likely?

1. Bacterial meningitis
2. Acute extradural haematoma
3. Sudden-onset Alzheimer’s dementia
4. Chronic subdural haematoma

Answer: D) Chronic subdural haematoma. Chronic subdural haematoma is common in older adults and anticoagulated clients after minor trauma, with symptoms evolving over weeks. A CT scan is needed.