A 77-year-old woman is confused and combative. Her daughter states that she has been gradually "acting strange" since waking up this morning. The patient has a history of alcoholism, and reportedly fell two weeks ago. Given your knowledge of the changes associated with aging, you should maintain a high index of suspicion for:

Question

Quizplus · Accepted Answer

The patient's history of alcoholism and recent fall put her at risk for a subdural hematoma, which can result in confusion, combative behavior, and a gradual onset of symptoms. Internal hemorrhage and hypokalemia could also be contributing factors, but the history and presentation suggest a subdural hematoma as the most likely cause. Acute alcohol intoxication may be a differential diagnosis, but the gradual onset of symptoms and history of alcoholism suggest a more chronic and potentially serious underlying issue.

A 77-Year-Old Woman Is Confused and Combative