A case of ruptured aneurysm with subarachnoid hemorrhage in elderly patient. The Pitfall of Medical Examination: Case Report.:-The Pitfall of Medical Examination : Case Report-

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We report a case of ruptured aneurysm with subarachnoid hemorrhage (SAH) in an elderly patient. An 89-year-old man suffered from disturbance of consciousness and was admitted to our hospital. He had been operated on for bilateral chronic subdural hematomas 6 months before. He suffered from headache both before and during admission. His consciousness was rated 10 by the Japanese coma scale, and he showed right hemiparesis. A computed tomographic scan revealed left chronic subdural hematomas with a depressed frontal lobe. The left Sylvian fissure was unclear. On reviewing the course of the illness, we suspected subarachnoid hemorrhage. Cerebrospinal fluid samples obtained at lumbar puncture showed xanthochromia. Therefore, SAH was diagnosed. All treatment was refused by the family. Four days later, the patient's consciousness level worsened to coma and the patient expired. A computed tomographic scan revealed reformation of SAH.<BR>Recently, average life-spans have been increasing along with the number of elderly people. Thus, the chance of encountering a ruptured aneurysm in elderly patients is also increasing. When we undertake physical examinations of elderly patients, we consider it essential to understand the background of each patient and their chief complaints without being influenced by their past history.
昭和大学・昭和医学会の論文