Abstract：
BACKGROUND:Predicting the fate of patients who are given a misdiagnosis of aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. The purpose was to examine factors associated with initial misdiagnosis of aSAH and to investigate the impact of initial misdiagnosis of aSAH on clinical outcomes. METHODS:Between January 2007 and December 2015, medical records and radiographic data for 3118 consecutive patients with aSAH were reviewed. There were 33 patients who had been documented with an initial misdiagnosis of aSAH, and all met the following criteria: (1) failure to correctly identify aSAH upon initial presentation to health care professionals; and 2) subsequently documented aSAH after the initial misdiagnosis. After applying exclusion criteria, remaining 2898 patients were included in the control group. RESULTS:The most common cause of the misdiagnosis is failure to detect aSAH on the initial radiographic imaging. Misdiagnosis group showed lower initial Glasgow Coma Scale, better Hunt-Hess grade, and lower Fisher's grade. Logistic regression analysis showed that initial HH grade (OR, 0.216; p = 0.014), initial Fisher's grade (OR, 0.732; p = 0.036), and hospital type during initial contact (OR, 2.266; p = 0.042) were independently associated with misdiagnosis of aSAH. CONCLUSIONS:Patients with initially good HH grade, lower Fisher's grade, and visiting non-teaching hospital for initial contact were at risk of being misdiagnosed. Misdiagnosis of aSAH in patients with initial good HH grade did affect clinical outcomes negatively. The rebleeding rate was not significantly different between two groups. However, the mortality rate due to rebleeding was higher in MisDx group than in non-MisDx group.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Oh SY,Lim YC,Shim YS,Song J,Park SK,Sim SY,Kim MJ,Shin YS,Chung Jdoi
10.1007/s00701-018-3552-6subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1105-1113issue
6eissn
0001-6268issn
0942-0940pii
10.1007/s00701-018-3552-6journal_volume
160pub_type
杂志文章abstract：:The main aim in the surgery of the canalicular and extracanalicular lumbar disc herniation is to remove safely the hidden fragment without complete destruction of the normal facet joint, without damage to the nerve root and with minimal compromise of the stability of the spinal column. This report describes a lateral ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01456353
更新日期：1987-01-01 00:00:00
abstract：BACKGROUND:Spinal epidural arachnoid cysts (EAC) are rare and may present with myelopathy, which can be completely curable with surgery. The majority of investigators believe that the repairment of dural defect is important to treat EAC. However, the necessity of excising EACs remains controversial. The purpose of this...
journal_title：Acta neurochirurgica
pub_type： 杂志文章,评审
doi：10.1007/s00701-012-1356-7
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abstract：BACKGROUND:Blood blister-like aneurysms (BBAs) pose a significant challenge to neurosurgeons and neuro-interventionalists. These fragile broad-based aneurysms have a propensity to rupture with minimal manipulation during surgical or endovascular explorations because, unlike saccular aneurysms, they lack all layers of t...
journal_title：Acta neurochirurgica
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doi：10.1007/s00701-014-2212-8
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s701-002-8277-6
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed b...
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doi：10.1007/s00701-014-2328-x
更新日期：2015-03-01 00:00:00
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journal_title：Acta neurochirurgica
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doi：10.1007/s00701-007-1487-4
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journal_title：Acta neurochirurgica
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doi：10.1007/BF02750999
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-010-0743-1
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journal_title：Acta neurochirurgica
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journal_title：Acta neurochirurgica
pub_type： 杂志文章,评审
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01403601
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01405860
更新日期：1976-01-01 00:00:00
abstract：:1. The use of rapid sequential gamma camera scintigraphy in conjunction with computer aided storage and evaluation of data has been shown to be a promising method for the analysis of CSF dynamics in man. 2. Using this method rapid flow of CSF in the basal cisterns can be studied. The further course of tracer activity ...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01405983
更新日期：1977-01-01 00:00:00
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/BF01411175
更新日期：1996-01-01 00:00:00
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/s00701-012-1610-z
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to assess the reliability of fluorescein sodium in predicting conclusive tissue diagnosis in stereotactic brain biopsies and to characterize features of contrast-enhancing and non-enhancing MRI lesions associated with fluorescence. METHODS:A total of 19 patients were studied, 1...
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pub_type： 杂志文章
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更新日期：2020-08-01 00:00:00
abstract：:The ES is a non-physiological stimulus of the brain. However it represents an important and indispensable part of stero-EEG investigation since it is an easily adjustable method, capable of inducing typical electro-clinical seizures. From the clinical and electrical responses elicited by ES and from the data of the st...
journal_title：Acta neurochirurgica
pub_type： 杂志文章
doi：10.1007/978-3-7091-8444-8_4
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journal_title：Acta neurochirurgica
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
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journal_title：Acta neurochirurgica
pub_type： 杂志文章
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更新日期：1979-01-01 00:00:00
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