2020 Volume 25 Issue 2 Pages 211-216
Although subarachnoid hemorrhage (SAH) is associated with high mortality, a missed or delayed diagnosis can sometimes occur. In this study, a group of SAH patients who were not diagnosed at their first visit were analyzed, and their initial status and outcomes were compared with those of a group of correctly diagnosed patients. Between April 2013 and October 2019, 399 patients were diagnosed with SAH at our hospital, and 30 (7.5%) were not diagnosed correctly at the first visit.
The mean age of these 30 patients was 61 years, and 25 were females (83%). Twelve patients (40%) did not experience headache. Eighteen patients (60%) initially visited a department other than the Department of Neurosurgery because of posterior cervical pain or visual symptoms, which can lead to a delayed diagnosis of SAH. Although misdiagnosed SAH was associated with significantly good World Federation of Neurosurgical Societies (WFNS) grades and modified Rankin scale (mRS) scores at discharge compared with correctly diagnosed SAH, 7 patients (23%) died. All fatalities had experienced rebleeding within 11 days from the onset of SAH.
Mild or atypical symptoms could be a risk factor for a delayed diagnosis of SAH. It is important to pay attention to these symptoms for an early definitive diagnosis and appropriate therapeutic intervention.
