After an elderly person suffers a head injury, they may develop unsteady gait, sluggishness, excessive sleepiness, or weakness on one side of the body two to three weeks later — a CT scan is recommended

A single cranial CT scan costs roughly 200–300 RMB.

The Chinese Medical Association Neurosurgery Branch and others have released the "Chinese Expert Consensus on Pharmacological Treatment of Chronic Subdural Hematoma." Chronic subdural hematoma is a pool of blood that slowly accumulates between the membranes of the brain. Professionally, it is a chronic space-occupying lesion formed by blood accumulation between the arachnoid mater and the dura mater. It "usually forms in the third week after cranial trauma" and is most common in the elderly. After surgery, the recurrence rate can reach 33%, and the mortality rate can reach 32%. For patients 90 years old and above, overall, only 24% recover well. Systematic review: globally, there are 3.39 to 39.1 new cases per 100,000 people annually; as age increases, this can triple for those 80 and older. The most common causes are trauma and falls, followed by chronic alcoholism, use of anticoagulants (blood-thinning drugs), and violent injury. Geriatrics review: clinical manifestations "typically include confusion, cognitive decline, gait disturbance, or lethargy, which may be similar to other geriatric syndromes." This review also states that incidence is increasing, related to the increased use of anticoagulants and antiplatelet drugs (such as aspirin and clopidogrel) and the increased susceptibility of the elderly to falls. Another literature review specifies that there is a period of time between the injury and the onset of symptoms, and the injury is usually very mild, so it is often overlooked. More than 50% of patients deny having been injured.

Zhang J 等 (2021). Expert consensus on drug treatment of chronic subdural hematoma. Chinese Neurosurgical Journal, 7(1), 47. https://doi.org/10.1186/s41016-021-00263-z ; Dziho A 等 (2025). Global prevalence and incidence of chronic subdural hematoma: A systematic review. Brain and Spine, 5, 105893. https://doi.org/10.1016/j.bas.2025.105893 ; Mathon B, Shotar E (2026). Diagnostic and therapeutic management of chronic subdural hematoma in elderly patients. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 24(1), 30-41. https://doi.org/10.1684/pnv.2026.1274 ; Iliescu IA, Constantinescu AI (2015). Clinical evolutional aspects of chronic subdural haematomas - literature review. Journal of Medicine and Life, 8(Spec Issue), 26-33：「the brain injury, usually minor」「patients deny the existence of a trauma in over 50% of the cases」. https://europepmc.org/article/MED/26361507

At the time of impact, it is often just a minor bump, and more than half of the elderly cannot say they were injured. Therefore, if you discover at home that someone is "suddenly confused lately, walking unsteadily, always wanting to sleep, or having weakness in one hand," first look back to ask if they have fallen or hit their head in the last two or three months, and then go for a CT. Its presentation is similar to other geriatric diseases; do not directly attribute it to "dementia" or "sequelae of a previous stroke." Elderly people taking aspirin, clopidogrel, warfarin, or new oral anticoagulants are at higher risk, as is long-term heavy drinking. For fall prevention, see Section 1, Item 13 (practicing balance and leg strength). If memory is getting worse year by year and is not caused by head trauma, see Section 17, Item 13 (Memory Clinic).