Ahmed Syed Viqar, Bonny Stephen, Chandra Sumit
Acute Medicine Department, Stepping Hill Hospital, Stockport, Manchester, UK.
BMJ Case Rep. 2011 Nov 15;2011:bcr0920114771. doi: 10.1136/bcr.09.2011.4771.
A 65-year-old female was admitted with an 8-week history of gradual onset headache. The headache was worse in the morning and on bending forwards. This was associated with 1 week history of vomiting and 1 day history of difficulty in walking. Medical history was unremarkable apart from treated hypothyroidism. There was no history of trauma. Observations and physical examination were entirely normal. Routine blood tests including the ESR and clotting profile were normal. Given the history had red flags for headache, a CT scan was ordered and this showed bilateral subdural haematomas. The patient was referred to the regional neurosurgical centre where the haematomas were evacuated with good recovery. A follow-up MRI brain and spine did not show any source of bleeding.
一名65岁女性因逐渐出现头痛8周入院。头痛在早晨及向前弯腰时加重。伴有1周呕吐史及1天行走困难史。除治疗过的甲状腺功能减退症外，病史无特殊。无外伤史。生命体征及体格检查完全正常。包括血沉和凝血指标在内的常规血液检查正常。鉴于该头痛病史有警示信号，遂行CT扫描，结果显示双侧硬膜下血肿。患者被转至地区神经外科中心，血肿得以清除，恢复良好。脑部及脊柱的随访MRI未显示任何出血源。
