Subarachnoid haemorrhage that a fire department first report
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The typical presentations in cases of subarachnoid haemorrhage (SAH) caused by cerebral aneurysm rupture include a headache, vomiting, giddiness, or unconsciousness.We herein report a case of SAH, in which the first call from a fire department reported an inhalation burn injury.The patient was a 53-year-old homeless man who had been living under a bridge that was hit by a fire. At the scene, the exposed surface of his face and upper extremities was sooty. He had second-degree burns, mainly to his nose. He was able to answer that he felt no pain but could not respond to the other questions and enter the ambulance by himself. On the way to our institution, however, he became restless. After arriving at our department, he was transferred to a bed on a stretcher. As he did not have any relative and had not depended on public assistance, the details of his past and family history were unclear. He attempted to sit up and could not respond to verbal stimulation. He was, therefore, restrained by the medical staff, and a sedative drug was administered. A computed tomography (CT) examination revealed an SAH, mainly in the basilar cistern, and an anterior interhemispheric fissure. CT angiography showed an aneurysm at the anterior communicating artery. Aneurysmal neck clipping was performed on the same day, and the patient was transferred to a nursing care facility...

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