"A fall leading to a good outcome"

In March 2015 my 84 year old mother was blown over when going to catch a bus and sustained a head injury. She was admitted to A&E in Inverclyde Royal in Greenock. Her condition deteriorated she was sent for for a CT scan. This showed a very large, previously undiagnosed, arachnoid cyst in her left hemisphere which was now bleeding. She was rushed to the Neurosurgey Unit in the Southern General in Glasgow and just in time the cyst was drained to relieve the pressure on her brain. Within 3 days she was back in Inverclyde and was well enough to go home within the week. A great result and much relief all round.

Prior to this fall, however, my mother had been deteriorating slowly over the past 5 years. Her walking was unbalanced, she was very unsteady moving in small spaces, her fine motor movenment was weak for writing and using cutlery and worst of all for her, her communication had become extremely poor. She had lost the ability to ask or answer questions and although she knew where she had been and what she had done she had such severe word finding problems she had more or less stopped speaking as she knew she struggled to express herself. She had been under investigation for a number of possible conditions but nothing was conclusive. Her movement was similar to Parkinson's disease, she had not had a stroke and her word finding was thought to be possible early dementia. At no point was a CT scan considered.

Since the cyst was drained she is like a 'new woman'. She can converse easily, her vocabulary has returned, her walking is still slow but she is able to negotiate small spaces. Her writing is back to normal and her fine motor movement is good enough not just to eat better but to be able to cook and sew again. She is enjoying reading and can concentrate on the TV. Even her hearing is better as she is now able to put in her hearing aids which had been a struggle so she didn't bother with them.

I am confident that if she maintains this level of improvement it will have given her back at least 5 more years of independence to continue to live in her own home.

I would urge clinicians dealing with the elderly not to make assumptions about conditions based on age and the increasing prevalence of dementia. If symptoms in a patient do not 'add up' then someone should be taking an overview of the impact on the person's life and looking at every possible reason for deterioration.

I don't know if she had been offered a CT scan earlier, and the cyst discovered, if anything would have been done as this kind of condition is rare but her family would have had a reason for her decline.

Thanks to the quick thinking of the medics in A&E in Greenock and the skills of the surgeons in Glasgow the marked improvemnt in her quality of live now is nothing short of miraculous and we are very grateful.