Low risk for subsequent subarachnoid hemorrhage for emergency…随后出现紧急蛛网膜下腔出血的低风险.pdfVIP

J Neurosurg 121:24–31, 2014 ©AANS, 2014 Low risk for subsequent subarachnoid hemorrhage for emergency department patients with headache, bloody cerebrospinal fluid, and negative findings on cerebrovascular imaging Clinical article Lisa E. Thomas, m.D.,1,2 amanDa D. CzuCzman, m.D.,2,3 aLyson B. BouLangEr, m.a.,2 DaviD a. PEak, m.D.,2 EmiLy s. miLLEr, m.D.,2 DaviD F. m. Brown, m.D.,2 anD kEiTh a. mariLL , m.D.2 1Department of Emergency Medicine, University of Maryland Upper Chesapeake Medical Center, Bel Air, Maryland; 2Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; and 3Department of Emergency Medicine, North Suburban Medical Center, Thornton, Colorado Object. When patients present to the emergency department (ED) with acute headache concerning for subarach- noid hemorrhage (SAH) and a lumbar puncture (LP) shows blood in the CSF, it is difficult to distinguish the results of a traumatic LP from those of SAH. CT angiography (CTA) is often performed, but the long-term outcome for patients with a positive LP and normal neurovascular imaging remains uncertain. The primary objective of this study was to determine whether patients who presented to the ED with acute headache and had red blood cells (RBCs) in their CSF on LP but negative cerebrovascular imaging su