Open AccessMissed Diagnosis of Subarachnoid Haemorrhage
Author(s) -
Teiko Kawahigashi,
Taro Shimiszu,
Takashi Kawabe,
Yoshitoshi Kida,
Kazunao Watanabe
Publication year - 2021
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2021_002616
Subject(s) - medicine , radiological weapon , lumbar puncture , subarachnoid haemorrhage , blurred vision , subarachnoid hemorrhage , radiology , disease , lumbar , surgery , cerebrospinal fluid , aneurysm , pathology
A 79-year-old woman presented with left retro-orbital pain, headache and blurred vision. Based on negative radiological tests, life-threatening conditions like subarachnoid haemorrhage (SAH) were ruled out and outpatient follow-up was planned. However, the patient returned to the hospital that night because of progressively declining consciousness and was diagnosed with SAH by head computed tomography. The diagnosis of SAH is often challenging, especially in cases with negative radiological results. We describe some strategies, other than radiological examination, for ruling out SAH, such as performing a lumbar puncture and repeating tests to take account of disease progression, and describe biases which can affect clinical decision-making.