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头颅CT检查阴性的蛛网膜下腔出血误诊临床分析

王起 徐晓彤 杨静

临床误诊误治2023,Vol.36Issue(7):23-27,5.
临床误诊误治2023,Vol.36Issue(7):23-27,5.DOI:10.3969/j.issn.1002-3429.2023.07.007

头颅CT检查阴性的蛛网膜下腔出血误诊临床分析

Clinical Analysis of Misdiagnosis of Subarachnoid Hemorrhage with Nega-tive head CT

王起 1徐晓彤 1杨静1

作者信息

  • 1. 100049 北京,航天中心医院神经内科
  • 折叠

摘要

Abstract

Objective To investigate the clinical features,diagnosis and treatment methods,causes of misdiagnosis and preventive measures of subarachnoid hemorrhage(SAH)with negative head CT.Methods The clinical data of 3 pa-tients with SAH who were misdiagnosed as viral encephalitis with negative head CT from June 2016 to June 2021 were retro-spectively analyzed.Results Three cases were admitted to hospital due to fever and headache for 4 d,sudden transient dis-turbance of consciousness,memory disturbance and fever for 2 d,and headache for 14 d,limb convulsions with loss of con-sciousness for 3 h,respectively.The clinical manifestations of the three cases were atypical,2 cases had fever and mental dis-orders,and 1 case was in epileptic state.The head CT examination was negative at the time of visit,and all cases were misdi-agnosed as viral encephalitis.SAH was confirmed after other imaging and cerebrospinal fluid examination by lumbar puncture.One patient remained in stable condition and two died.Conclusion Atypical SAH is more likely to be misdiagnosed.CT ex-amination of the head shows no obvious abnormality.For such patients,other imaging and cerebrospinal fluid examination by lumbar puncture should be performed as soon as possible to reduce or avoid misdiagnosis and treatment.

关键词

蛛网膜下腔出血/头痛/误诊/脑炎,病毒性/体层摄影术,螺旋计算机/磁共振成像/磁共振血管造影术/脊椎穿刺

Key words

Subarachnoid hemorrhage/Headache/Misdiagnosis/Encephalitis,viral/Tomography,spiral compu-ted/Magnetic resonance imaging/Magnetic resonance angiography/Spinal Puncture

分类

医药卫生

引用本文复制引用

王起,徐晓彤,杨静..头颅CT检查阴性的蛛网膜下腔出血误诊临床分析[J].临床误诊误治,2023,36(7):23-27,5.

临床误诊误治

OACSTPCD

1002-3429

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