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Headache,nausea,vomiting,and transient loss of consciousness occur in two thirds of people who experience subarachnoid haemorrhage.Loss of consciousness may result in an abrupt fall and trauma to the head immediately after the haemorrhage.The distinction between subarachnoid haemorrhage and head injury may therefore be blurred sometimes,with the spontaneous subarachnoid haemorrhage remaining unrecognized.We believe that this clinical problem has not been properly addressed.We report on four patients with head injury,in whom a spontaneous subarachnoid haemorrhage preceded the trauma,and suggest guidelines for investigating and managing such patients. |
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