Senile Dementia?

Can a severe head injury cause permanent dementia? My 76 year old mother was displaying "some" dementia symptoms before a couple of severe head injuries. Since the head injuries, she is much worse and doesn't seem to be improving at all. Can head injuries "escalate" dementia if it was in the early stages before the head trauma? Any thoughts?

Sure.

When you are talking about trauma to the head, it can do three things, separately or in combination:

1) cause a bleed because a blood vessel has been ruptured; this is more common in older people because their brains have gotten smaller with age (ie, atrophied), and there is not the tight fit of the brain with the skull as there is in younger people;
2) cause swelling that leads to some areas of the brain not getting enough oxygen, because the pressure prevents blood from getting to those areas and as a result, cells in these areas die off (this is called anoxic brain injury);
3) if severe enough, it can cause diffuse axonal injury, which is the shearing of axons. Your brain cells (the gray matter) are connected together via axons (the white matter), which are like tight strings. So when you have a massive decelerating force, like in an auto accident, those strings or axons are pulled to the point that they can be damaged.

"Senile" dementia is an older term, not very PC nowadays. Generally, physicians talk about two most common types of dementia in the elderly: Alzheimer's and vascular dementia.

Alzheimer's, by far, is the most common form of dementia. There are some theories to explain it, but no one quite knows what the cause is. However, on imaging, we see that some areas of the brain lose cells and mass (ie, atrophy), especially the memory-making areas. It is a gradual process, and so there is a gradual loss of memory, along with either difficutly naming objects, speaking, or doing normal tasks. People first diagnosed with Alzheimer's can often live for 10-20 years, and oftentimes die of other illnesses rather than the dementia.

The other major cause of dementia is vascular dementia. This can occur as a result of major strokes, which leave people with sudden deficits in their ability to function. If you suspect someone of having a stroke, call 911 right away. Vascular dementia can also be a result of problems with very small vessels in the brain over time (or "silent" strokes), so that gradually different areas die off. In general, people with vascular dementia have more of an abrupt pattern to their deficits, sometimes it is referred to as a "stepwise" pattern.

So, yes, head injury can make pre-existing dementia in the elderly worse. This is because the overall mechanisms that lead to dementia can be shared between the chronic or gradual dementias, as well as in head injury.

Call 911 right away if you suspect a head injury or a stroke. Talk to your doctor about ways---drug and lifestyle-based---to help slow down or manage the dementia.

Dementia is not the norm so get her in to see a doctor to find out what is causing it,. It may be something treatable or it might be Alzheimers but either way she needs to get checked and treated ASAP.

Ask her doctor...