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Abstract
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Dear Editor,
A 37-year-old healthy man presented with impaired consciousness and hypoxemia after drowning. While swimming together, his wife began to struggle in the water, prompting him to attempt to rescue her. His wife was successfully rescued. However, the patient nearly drowned, and despite being rescued, experienced cardiac arrest. Cardiopulmonary resuscitation was administered, and the pulse was reestablished. Due to ongoing hypoxemia and impaired consciousness, he was intubated by medical staff from a helicopter.
On arrival, he exhibited deep coma, high blood pressure, and sinus tachycardia. On a physical examination, no external trauma was observed; however, moist rales were heard in both lung fields. A 12-lead electrocardiogram revealed sinus tachycardia. Blood tests indicated leukocytosis and mild liver and kidney dysfunction. A whole-body computed tomography (CT) revealed a small amount of subarachnoid hemorrhaging near the left central sulcus of the frontal lobe [Figure 1], bilateral maxillary sinus fluid accumulation, and infiltrative shadows in both lungs. On day 2, as the respiratory status improved, extubation was performed. Due to incomplete awakening and worsening respiratory status, reintubation was required. On day 4, the patient was confirmed to be adequately awake, and extubation was repeated. A head magnetic resonance imaging (MRI) and contrast-enhanced CT did not reveal any clear sources of bleeding. The patient was discharged on day 7 without neurological deficits.
This case represents a unique occurrence of subarachnoid hemorrhaging without a clear source during drowning, with no prior reports of such a combination. Previously, there have been cases in which subarachnoid hemorrhaging occurred as a complication of asphyxiation, stemming from...
Language: en |