首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Do negative CCT and CSF findings exclude a subarachnoid haemorrhage? A retrospective analysis of 220 patients with subarachnoid haemorrhage.
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Do negative CCT and CSF findings exclude a subarachnoid haemorrhage? A retrospective analysis of 220 patients with subarachnoid haemorrhage.

机译:CCT和CSF阴性结果是否排除蛛网膜下腔出血?回顾性分析220例蛛网膜下腔出血患者。

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OBJECTIVE: Subarachnoid haemorrhage (SAH) constitutes a neurological emergency. In most cases, the diagnosis is easy to establish; however, in rare cases, verification of the diagnosis is difficult. In this retrospective analysis, we report the clinical characteristics of patients with SAH who were admitted to our neurological intensive care unit. We focus on the additional diagnostic approaches in patients with a high suspicion of SAH but failure of the 'classic' diagnostic tools. METHODS: A retrospective chart review was performed for all patients in whom SAH was diagnosed between 1996 and 2008. Two hundred and twenty patients were analysed for presenting symptoms, radiological and laboratory findings, hospital course and outcome. RESULTS: A total of 220 patients were identified (mean age 50.5 years, 127 women). In 217 patients, the diagnosis was based upon cerebral computed tomography (CCT) or lumbar puncture. In three patients, the diagnostic work-up was continued because of distinct clinical signs even though CCT and cerebrospinal fluid (CSF) were negative for SAH. In these patients, vasospasm was detected by transcranial doppler sonography (TCD) and/or diagnosis of aneurysm was confirmed by conventional angiography. CONCLUSION: Subarachnoid haemorrhage with negative CCT and CSF is a rare presentation of a severe acute neurological emergency. Further diagnostic as TCD/computed tomography (CT)-A or MR-A should be considered in all patients with typical clinical presentation for SAH but unremarkable CCT and CSF as an additional diagnostic tool. Ultimately, a conventional angiography should be performed if distinct clinical signs of SAH are presented.
机译:目的:蛛网膜下腔出血(SAH)构成神经系统紧急情况。在大多数情况下,诊断很容易确定。但是,在极少数情况下,很难进行诊断验证。在这项回顾性分析中,我们报告了进入我们神经内科重症监护病房的SAH患者的临床特征。我们将重点放在对SAH高度怀疑但“经典”诊断工具无效的患者中的其他诊断方法。方法:对1996年至2008年间所有诊断为SAH的患者进行回顾性图表审查。分析了220名患者的症状,影像学和实验室检查结果,医院病程和结局。结果:总共鉴定出220例患者(平均年龄50.5岁,女性127例)。在217例患者中,诊断基于脑计算机断层扫描(CCT)或腰穿。在三例患者中,尽管CCT和脑脊液(CSF)的SAH阴性,但由于明显的临床体征,仍继续进行诊断检查。在这些患者中,经颅多普勒超声检查(TCD)可检测到血管痉挛和/或常规血管造影可确诊为动脉瘤。结论蛛网膜下腔出血伴CCT和CSF阴性是严重的急性神经系统紧急情况的罕见表现。对于所有典型的SAH临床表现,但CCT和CSF均不明显的患者,应考虑进一步诊断为TCD /计算机断层扫描(CT)-A或MR-A。最终,如果出现SAH的明显临床体征,则应进行常规血管造影。

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