Delayed diagnosis in subarachnoid haemorrhage.
OBJECTIVE
To determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in whom the diagnosis was delayed.


METHODS
A two-year retrospective study of medical records of patients admitted to Westmead Hospital between July 1988 and June 1989.


METHODS
A tertiary level teaching hospital.


METHODS
Ninety-four patients treated for subarachnoid haemorrhage. In 15 cases the diagnosis was delayed.


METHODS
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 of a computed tomography scan are diagnostic only if they are positive--a negative result must be interpreted in conjunction with the clinical picture.
Chan
B S
BS
Westmead Hospital, NSW.
Dorsch
N W
NW
D000208:Acute Disease; D000328:Adult; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology