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Subdural haematoma — DGM MCQ

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ModerateFallsSubdural haematomaDGM

An 87-year-old man presents two weeks after a fall with new headache and confusion. He takes anticoagulation for atrial fibrillation. Examination shows mild right arm drift. Current medicines include warfarin. What is the most appropriate management?

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Correct answer: B — Urgent hospital assessment with CT head

Delayed headache, confusion and focal neurology after head injury in an anticoagulated older person suggest intracranial bleeding and require urgent CT head. Falls clinic, antipsychotic treatment and physiotherapy would delay diagnosis; increasing warfarin is unsafe. Subdural haematoma may present subtly in older adults after apparently minor trauma.

Reference: NICE head injury guidance; NICE NG249