Aisiku Imoigele, Edlow Jonathan A, Goldstein Joshua, Thomas Lisa E
Assistant Professor, Harvard Medical School Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
Professor of Medicine, Harvard Medical School; Vice-Chair, Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Boston, MA.
Emerg Med Pract. 2014 Oct;16(10):1-29; quiz 29-30. Epub 2014 Oct 1.
Aneurysmal subarachnoid hemorrhage accounts for a small percentage of strokes, but it is a significant contributor to the morbidity rate. The diagnosis is challenging and has devastating consequences if it is missed. Accurate initial diagnosis and management are critical to the outcome of the disease. The emergency clinician must have a high index of suspicion and a judicious approach to evaluating the chief complaint of patients with spontaneous subarachnoid hemorrhage (ie, headache). This review evaluates the literature and current evidence, including controversies and recent American Heart Association guidelines, to support a best-practice approach to the diagnosis and treatment of patients with spontaneous subarachnoid hemorrhage.
动脉瘤性蛛网膜下腔出血在中风中所占比例较小,但却是发病率的一个重要促成因素。其诊断具有挑战性,若漏诊会产生灾难性后果。准确的初始诊断和管理对疾病的预后至关重要。急诊医生必须对自发性蛛网膜下腔出血(即头痛)患者的主要诉求有高度的怀疑指数和明智的评估方法。本综述评估了相关文献和当前证据,包括争议点及美国心脏协会的最新指南,以支持对自发性蛛网膜下腔出血患者进行诊断和治疗的最佳实践方法。