小量脑出血42例临床误诊分析

目的 :探讨小量脑出血的早期诊断 ,防止误诊。方法 :对 42例被误诊的大脑半球小量 (≤ 10m1)脑出血患者的发病形式和临床表现进行分析 ,并与同期住院的脑出血 (>10m1)和脑梗死患者作对照。结果 :本组患者误诊原因主要为非重要功能区部位出血、颅内压增高症状少、肢体功能障碍轻、临床表现不典型。在头痛、呕吐、颈抵抗、意识障碍及双侧巴氏征阳性方面与脑出血组有极显著差异 (P <0 0 1) ,而与脑梗死组差异不显著 (P >0 0 5 ) ;在既往无卒中史 ,活动时起病及发病时血压高等方面与脑出血组比无显著差异 (P >0 0 5 ) ,而与脑梗死组比有显著或极显著差异 (P <0 0 5～ 0 0 1)。结论 :小量脑出血早期不易诊断 ,CT检查可避免误诊

Clinical misdiagnosis analysis in 42 patients with little cerebral hemorrhage

Objective: To study the early diagnosis of little cerebral hemorrhage and avoid misdiagnosis. Methods: The beginning form of disease and clinical manifestations of 42 misdiagnosed patients with little cerebral hemorrhage(≤10 ml) were analyzed and compared with other patients who suffered cerebral hemorrhage (>10 ml) or cerebral infarction in hospital at the same time. Results: Unimportant function of bleeding place, lack of symptom of intracranial hypertension, light functional disturbance and no typical clinical exhibition were chief reasons of misdiagnosis. There were significantly difference in headache, vomit,neck rigidity,disorders of consciousness, both Babinski sign positive compared with cerebral hemorrhage group ( P <0.01).and there were significantly difference in no previons stroke, disease beginning with moving or blood pressure rising compared with cerebral infarction group ( P <0 05～0 01).Conclusion: It is not easy to diagnose little cerebral hemorrhage early.CT can prevent from misdiagnosis