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Revista Uruguaya de Medicina Interna
Print version ISSN 2393-6797On-line version ISSN 2393-6797
Abstract
BENTANCOURT, Verónica; JAUME, Alejandra and ABOAL, Carlos. Misdiagnosis in aneurysmal subarachnoid hemorrhage. Rev. Urug. Med. Int. [online]. 2016, vol.1, n.3, pp.62-68. ISSN 2393-6797.
ABSTRACT Introduction: While subarachnoid hemorrhage accounts for 5% of accidents cerebrovascular determines high morbidity and mortality. His presentation, frequent-mind with headache and vomiting, determined to be confused diagnosis with other entities. Materials and methods: All cases of subarachnoid hemorrhage underwent surgical Interventions in a hospital, for 5 years were analyzed. Patronymic record data, data were recorded days from the onset of symptoms to diagnosis, complications, clinical grade at baseline and at the time of diagnosis and imaging studies. Results: 90 cases of subarachnoid hemorrhage underwent surgery during the study period were found. a delayed diagnosis of 44.4% was recorded. 35% of these patients had complications, compared with 16% in patients with diagnostic appropriate. 35% of patients increased clinical grade. 70% of the delay was attributed to a misdiagnosis, 25% to the absence of consultation with the patient, and 5% to the delay in the study and / or transfer the patient to a tertiary care center. Discussion and conclusions: The proportion of patients with delayed diagnosis is higher than reported in the last decade, however, the complication rate is similar or even lower than found in reference centers. Delayed diagnosis determines an increase of clinical grade and prognosis worsens accordingly. The largest proportion of patients in whom not reach a timely diagnosis is attributed to the absence of clinical suspicion of pathology.
Keywords : Subarachnoid hemorrhage; misdiagnosis; delayed diagnosis.