Jaffery Aleq, Morchel Herman, Poon Jessica
Department of Emergency Medicine, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ, 07601, USA.
Hackensack Meridian School of Medicine, 340 Kingsland St, Nutley, NJ, 07110, USA.
Int J Emerg Med. 2023 Jan 5;16(1):1. doi: 10.1186/s12245-023-00476-2.
Subarachnoid hemorrhage (SAH) is a diagnosis that emergency physicians must have a high index of suspicion for. Many common chief complaints such as headache, nausea, altered mental status, and even syncope may alert clinicians to the possibility of a SAH.
The authors present an unusual case of SAH in a patient presenting with acute dyskinesia and altered mental status, which has seldom been documented as the presenting feature of SAH, as well as the diagnostic pitfalls encountered in assessing this patient.
Emergency physicians should maintain a high index of suspicion for dangerous pathology in cases without a clear etiology; they should also utilize metacognition to assess their own biases and thought patterns so as to avoid missing critical diagnoses.
蛛网膜下腔出血(SAH)是一种急诊科医生必须高度怀疑的诊断。许多常见的主要症状,如头痛、恶心、精神状态改变,甚至晕厥,都可能提醒临床医生注意SAH的可能性。
作者报告了一例不寻常的SAH病例,该患者表现为急性运动障碍和精神状态改变,这种情况很少被记录为SAH的首发特征,以及在评估该患者时遇到的诊断陷阱。
急诊科医生在病因不明的病例中应高度怀疑存在危险病理;他们还应运用元认知来评估自己的偏见和思维模式,以避免漏诊关键诊断。