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Delayed diagnosis in subarachnoid haemorrhage
Author(s) -
Chan Betty S H,
Dorsch Nicholas W C
Publication year - 1991
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1991.tb119442.x
Subject(s) - subarachnoid haemorrhage , medicine , subarachnoid hemorrhage , radiology , surgery , aneurysm
Objective: To determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in who,“ the diagnosis w.as delayed. Design: A two‐year retrospective study of medical records of patients admitted to Westmead Hospital between July 1988 and June 1989. Setting: A tertiary level teaching hospital. Patients: Ninety‐four patients treated for subarachnoid haemorrhage. In 15 cases the diagnosis was delayed. Main outcome measures: Death, disability, or functional recovery. Results: Overall, 40 (42.5%) patients died, 14 (15%) were disabled, and 40 made a functional recovery. Of the 62 patients who were treated surgically 38 (61%) made a functional recovery compared with two of the 32 (6%) who were not. Of the 15 in whom the diagnosis was delayed seven (47%) made a functional recovery. Confirmation of the diagnosis was delayed in four of the latter group because a cranial computed tomography scan showed no abnormalities. Conclusions: Earlier diagnosis, allowing early definitive surgical treatment, may improve the outcome in aneurysmal subarachnoid haemorrhage; The results ofa computed tomography scan are diagnostic only if they are positive ‐ a negative result must be interpreted in conjunction with the clinical picture.