Clinical Analysis of Misdiagnosed Cerebral Infarction in Elderly Patients with Small Amount of Cerebral Hemorrhage
MO Jianbing
YAO Gengqi
PU Jingli
YANG Zhou
Abstract：Objective To analyze the causes and preventive measures of misdiagnosis of cerebral infarction in senile patients with small amount of cerebral hemorrhage.Methods The medical records of 10 elderly patients with small amount of cerebral hemorrhage who were early misdiagnosed as cerebral infarction were selected from January 2021 to January 2023.Re-sults There were 7 males and 3 females in this group who were aged 61-72 years.All had a history of hypertension and acute attack,including static(while sleeping or at rest)disease in 3 patients and dynamic disease in 7 patients.Blood pressure was elevated in all 10 patients.There was dizziness in 9 patients,mild headache in 2 patients,speech impairment in 6 patients,mild central facial and lingual paralysis in 3 patients,and hemiplegia in 7 patients,and none of them had disturbance of con-sciousness or vomiting.The initial diagnosis was cerebral infarction in the local township health center or clinic.After symp-tomatic treatment,the clinical symptoms did not significantly improve or worsen,and then they were transferred to our hospi-tal.After comprehensive analysis of the condition,CT examination of the head showed basal ganglia hemorrhage in 5 patients,thalamic hemorrhage in 4 patients,temporal lobe hemorrhage in 1 patient,and the middle line structure and narrowing of the lateral ventricle due to compression in 4 patients.The blood loss was 2.9-7.3 mL,with an average of 5.1 mL.All patients were diagnosed as small amount of cerebral hemorrhage,and the duration of misdiagnosis was 4-5 d.After diagnosis,10 pa-tients were treated with drugs such as controlling blood pressure and dehydration,maintaining water and electrolyte balance,nourishing the brain and nerves,promoting blood circulation and removing stasis.After 3 to 4 weeks,the symptoms and signs basically returned to normal,and the head CT examination showed that hematoma had been obviously absorbed,showing favor-able prognosis.Conclusion Due to the physiological and pathological characteristics of the elderly,small amount of cerebral hemorrhage in the early stage lacks typical manifestations of elevated intracranial pressure,and meningeal irritation in the early stage,such as headache and vomiting,coupled with a small amount of blood loss and no significant space-occupying effect,which makes it more likely to consider cerebral infarction before performing CT and other imaging examinations in the early stage.Strengthening the understanding of the attending physicians for small amount of cerebral hemorrhage in the elderly,rai-sing their vigilance,paying attention to the manifestation of elevated blood pressure and the state of onset,and performing CT and other imaging examinations as early as possible can help improve the early diagnosis rate of this disease.
Keywords：Small amount of cerebral hemorrhageElderlyMisdiagnosisCerebral infarctionTomographyspiral computedConsciousness disordersIntracranial pressureMeningeal irritation sign
Publication Date：2024-07-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 23-26 )