Misdiagnosis of subarachnoid hemorrhage is not typical.doc

 PAGE \* MERGEFORMAT 7 Misdiagnosis of subarachnoid hemorrhage is not typical General subarachnoid hemorrhage (subarachnoid hemorrhage, SAH) is easy to diagnose, but a few are not typical of SAH easily misdiagnosed, treated in our hospital, 5 cases are reported as follows. A clinical data Example 1, male, 55 years old. March 19, 1994, headache, palpitations, syncope 1h. Out-patient ECG: sinus bradycardia with arrhythmia, frequent sinus arrest, junctional escape rhythm. Admission palpation: T 36.1 ℃ , BP 225/105mmHg, conscious, neck soft. Heart rate 62 times / min, law is incomplete, and did not hear pathological murmur. Klinefelter syndrome, Brinell negative sign. The control of blood pressure treatment, progression-free turn for the better. First 3 days vomiting, neck stiffness palpation, g’s sign positive. Brain CT and CSF examination for diagnosis of SAH. Example 2, male, 76 years old. September 30, 2000 due to more than 10 days, pairs of lower limb weakness, headache, vomiting 3 days hospitalization. Palpation: T 36.5 ℃ , BP 134/107mmHg, conscious. Suspicious neck rigidity, Klinefelter syndrome, Brinell negative sign. Three pairs of lower extremity muscle strength, muscle tone and tendon reflexes normal. Brain CT prompts brain atrophy. After symptomatic treatment without improvement. Day 2 appeared low back pain. Palpation g’s sign positive. Cerebrospinal fluid examination for diagnosis of SAH. Example 3, female, 80 years old. August 29, 2001 Sudden dizziness, headache, vomiting, 2h hospital. Past history of a cervical vertebra. Palpation: T35.9 ℃ , BP190/90mmHg, conscious, such as pairs of pupils and other large circle diameter of 0.25cm, light reflex sensitivity, no nystagmus. Neck soft g’s syndrome, Brinell negative sign. The control of blood pressure, improve the treatment of brain blood supply, etc. No improvement. The first two days there neck pain. Body found in search neck stiffness, double g’s sign positive. Brain CT and CSF examination for di