Case
Published · Updated · 2 min read
Trauma after a fall in a 91-year-old man: hemorrhagic stroke identified
What it means for practice
Older patients with cardiovascular risk factors require a thorough physical examination after a fall: the trauma may be secondary to an acute neurological event.
Summary
Clinical presentation
A 91-year-old man with hypertension and dyslipidemia fell while pruning. He was taking ramipril and atorvastatin. Initial complaints included pain in the right limb and shoulder, without chest pain or palpitations. The case is presented as trauma secondary to a hemorrhagic stroke, rather than solely as an injury sustained during physical work.
Diagnostic finding
Computed tomography revealed a hemorrhagic stroke, likely related to hypertension. In the account, the stroke is therefore considered the primary event and the trauma its consequence. The supplied abstract does not report an association between the stroke and ramipril or atorvastatin use.
Practical emphasis
The authors emphasize thorough physical examination to prevent diagnostic errors, particularly in older adults with cardiovascular risk factors. They also highlight challenges in rural healthcare settings. The supplied abstract does not provide details of the neurological examination, treatment, or subsequent clinical course.
Case analysis
- Likely mechanism
- The supplied abstract describes the trauma as a consequence of a hemorrhagic stroke, likely caused by hypertension. It does not describe a mechanism of an adverse drug reaction.
- Causality assessment
- The supplied abstract reports neither a Naranjo score nor a WHO-UMC category. No suspected drug is identified; the information is insufficient for an editorial assessment of a causal relationship between pharmacotherapy and the stroke.
- Take-home lesson
- A fall with trauma in an older patient may reflect an acute neurological event. Thorough physical examination is particularly important when cardiovascular risk factors are present.
Source
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Traumatismo secundario a ictus hemorrágico.
Reviewed by: DrugCard editorial team ·
This article does not replace clinical judgement. Disclaimer
