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首例联合诊断细菌性脑膜炎和胶样囊肿性脑积水:奥卡姆剃刀如何变成希卡姆的定论。

First reported case of hydrocephalus in jointly diagnosed bacterial meningitis and a colloid cyst: how Ockham's razor became Hickam's dictum.

机构信息

Department of Neurosurgery, Institute of Neurological Sciences, Glasgow, UK.

出版信息

Br J Neurosurg. 2022 Jun;36(3):420-423. doi: 10.1080/02688697.2022.2077911. Epub 2022 May 24.

Abstract

We report the first case in the literature of acute hydrocephalus due to a simultaneous diagnosis of bacterial (not asceptic) meningitis and a colloid cyst. Diagnosing disease is the cornerstone skill of a medical practitioner. Both education and experience allow for sharpening of this skill throughout years of medical practice. Disease is fraught with nuances and inconsistencies which can render an accurate diagnosis a difficult task. Medical practitioners can be guilty of cognitive biases such as Ockham's razor. We present the case of a patient with an initial diagnosis of obstructive hydrocephalus secondary to a colloid cyst. However, pneumococcal meningitis blunted Ockham's razor in favour of Hickam's dictum.

摘要

我们报告了文献中首例因同时诊断出细菌性(非无菌性)脑膜炎和胶样囊肿而导致的急性脑积水的病例。诊断疾病是医学从业者的基石技能。教育和经验都可以使这种技能在多年的医疗实践中得到提高。疾病充满了细微差别和不一致之处,这使得准确诊断变得困难。医学从业者可能会犯奥卡姆剃刀等认知偏差的错误。我们介绍了一例最初诊断为胶样囊肿继发梗阻性脑积水的患者,但由于患了肺炎球菌性脑膜炎,希卡姆的训诫削弱了奥卡姆剃刀的作用。

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