Lund-Johansen M, Wester K
Nevrokirurgisk avdeling, Haukeland Sykehus, Bergen.
Tidsskr Nor Laegeforen. 1994 Nov 10;114(27):3175-8.
A total of 123 patients with subarachnoid haemorrhage were admitted to the Department of Neurosurgery, Haukeland Hospital, during the years 1990-93. In 16 patients, there was a delay from the first haemorrhage until diagnosis and treatment. In eight patients, the delay was caused by incorrect medical diagnosis, while two patients did not seek medical attention immediately after onset of symptoms. In the remaining six patients, the delay was caused by both patient and physician. In all but one patient, the first symptom was an unusually severe acute headache which in some cases was accompanied by nausea and vomiting, in others not. Altogether nine patients suffered renewed bleeding, and three patients died. Three patients showed neurological impairment postoperatively. The article deals with the importance of early diagnosis in patients with subarachnoid bleeding, and suggests how these patients should be handled by their primary doctors and at the hospitals to which they are referred.
1990年至1993年间，共有123例蛛网膜下腔出血患者入住豪克兰德医院神经外科。16例患者从首次出血到诊断和治疗存在延迟。8例患者的延迟是由错误的医学诊断导致的，而2例患者在症状出现后未立即就医。其余6例患者的延迟是患者和医生双方造成的。除1例患者外，所有患者的首发症状均为异常严重的急性头痛，部分病例伴有恶心和呕吐，部分病例则没有。共有9例患者再次出血，3例患者死亡。3例患者术后出现神经功能障碍。本文论述了蛛网膜下腔出血患者早期诊断的重要性，并就这些患者的初级医生以及转诊医院应如何处理这些患者提出了建议。
