Clinical Analysis of Misdiagnosis of Subarachnoid Hemorrhage with Nega-tive head CT
WANG Qi
XU Xiaotong
YANG Jing
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.
Keywords：Subarachnoid hemorrhageHeadacheMisdiagnosisEncephalitisviralTomographyspiral compu-tedMagnetic resonance imagingMagnetic resonance angiographySpinal Puncture
Publication Date：2023-07-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 23-27 )