Bazer Danielle A, Koroneos Nicholas, Orwitz Matthew, Amar Jordan, Corn Ryan, Wirkowski Elizabeth
Stony Brook University Hospital, Department of Neurology, Stony Brook, New York.
Johns Hopkins Medicine, Department of Neurology, Baltimore, Maryland.
Clin Pract Cases Emerg Med. 2023 Aug;7(3):175-177. doi: 10.5811/cpcem.1586.
Radiologically negative subarachnoid hemorrhage (SAH) has a low incidence and is associated with good clinical outcomes.
We present the case of a 44-year-old male with new-onset headaches, which began one week prior while bike riding. At an outside hospital, he had normal computed tomography head and angiogram. He declined a lumbar puncture. Over the following week, the headache was persistent. He lacked meningeal signs. Repeat studies were normal. Lumbar puncture was positive for xanthochromia.
Radiologically negative SAH should be included in the differential diagnosis of patients presenting with unremitting headache in the setting of recent exercise, despite negative imaging, and meningeal signs.
放射学检查呈阴性的蛛网膜下腔出血（SAH）发病率较低，且临床预后良好。
我们报告一例44岁男性患者，其出现新发头痛症状，始于一周前骑自行车时。在一家外部医院，他的头部计算机断层扫描和血管造影结果正常。他拒绝进行腰椎穿刺。在接下来的一周里，头痛持续存在。他没有脑膜刺激征。重复检查结果正常。腰椎穿刺显示脑脊液黄变试验呈阳性。
对于近期运动后出现持续性头痛、影像学检查阴性且无脑膜刺激征的患者，鉴别诊断时应考虑放射学检查呈阴性的SAH。
