Missed Diagnosis of Subarachnoid Haemorrhage

  • Teiko Kawahigashi Department of Emergency Medicine, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan
  • Taro Shimiszu Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
  • Takashi Kawabe Department of Emergency Medicine, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan
  • Yoshitoshi Kida Department of Emergency Medicine, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan
  • Kazunao Watanabe Department of Surgery, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan

Keywords

Emergency medicine, subarachnoid hemorrhage, diagnostic error

Abstract

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.

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References

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  • Published: 2021-05-31

    Issue: 2021: Vol 8 No 5 (view)

    Section: Articles

    How to cite:
    1.
    Kawahigashi T, Shimiszu T, Kawabe T, Kida Y, Watanabe K. Missed Diagnosis of Subarachnoid Haemorrhage . EJCRIM 2021;8 doi:10.12890/2021_002616.