Several weeks ago, I wrote about my husband's sudden decline-losing his clarity of speech and his inclination to speak, loss of appetite, even worse balance issues. I had assumed that 3 years from the diagnosis of PSP, his relative slow decline had made up for lost time. I was wrong. During one of his multiple falls, he broke his rib. On a follow doctor's visit, I asked about the slurred speech which the doctor has noted. After a quick check for a UTI, he sent us to the hospital immediately for a CT scan. Steve was diagnosed with a subdural hematoma. Our neurologist's best guesstimate was that the bleed had been going on for 3 to 6 weeks...possibly longer. He was classified as a chronic not a critical bleed and so while surgery was necessary, it wasn't deemed an emergency need. That was good news because what the neurologist and the neuro surgeon missed was that Steve has been on anti-coagulants (Plavix and aspirin) for his heart for several years. He was transported for surgery, but then held as his platelet count was far to low. Three days later he was discharged and told to return in a week when his platelets had a chance to regenerate.
On Dec. 18, Steve had what is called "burr hole" surgery during which "small" holes were drilled into his cranium and the blood and cerebral fluid vacuumed out. Some how I didn't expect two "small" holes to require 19 staples to close, but that is what we have. Almost immediately upon recovering from anesthesia, Steve's speech had returned to clarity and animation. The initial surgery removed over 8 ounces of fluid. Over the next 3 days an additional 3 ounces of fluid drained. I guess what we learned is not to assume sudden changes are automatically a progression of the disease. In hindsight, I think the bleed may well have been older than 3 weeks because of the increase in symptoms I had simply attributed to PSP.
PSP Clinic
Sudden return of speech. 
Sudden deterioration after inhaler
PSP and Hydrocephalus
Rapid Decline?
