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[目的]探讨老年性出血性脑血管病误诊原因，为临床诊断提供指导。[方法]收集本院2009年5月至2012年4月42例老年性脑出血误诊病例资料，分析误诊原因及诊治结果。[结果]42例误诊病例中，6例误诊为癫痫，5例误诊为消化性溃疡出血，2例误诊为心律失常，6例误诊为高血压脑病，3例误诊为紧张性头痛，2例误诊为急性酒精中毒，4例误诊为一氧化碳中毒，4例误诊为老年性痴呆，6例误诊为椎基底动脉供血不足，2例误诊为短暂性脑缺血性发作，2例误诊为急性上呼吸道感染。30例行腰穿检查，24例为血性脑脊液，C T检查发现42例均存在出血性改变。[结论]老年性出血性脑血管病易被误诊为癫痫、消化性溃疡性出血、高血压脑病等症，行头颅CT检查可有效确诊。“,”[Objective]To explore the causes of misdiagnosis of senile hemorrhagic cerebral vascular dis-ease in order to provide the guideline of clinical diagnosis .[Methods] The data of 42 cases of senile cerebral hemorrhage in our hospital from May 2009 to April 2012 were collected .The cause of misdiagnosis and the re-sults of diagnosis and treatment were analyzed .[Results] Among 42 misdiagnosis patients ,6 patients were misdiagnosed as epilepsy ,and 5 patients were misdiagnosed as peptic ulcer hemorrhage ,and 2 patients were misdiagnosed as arrhythmia ,and 6 patients were misdiagnosed as hypertensive encephalopathy ,and 3 patients were misdiagnosed as tension headache ,and 2 patients were misdiagnosed as acute alcohol poisoning ,and 4 pa-tients were misdiagnosed as carbon oxide poisoning ,and 4 patients were misdiagnosed as senile dementia ,and 6 patients were misdiagnosed as vertebro basilar artery insufficiency ,and 2 patients were misdiagnosed as tran-sient cerebral ischemia ,and 2 patients were misdiagnosed as acute upper respiratory infection .Lumbar punc-ture of 30 patients showed 24 cases of hemorrhagic cerebrospinal fluid .CT examination revealed 42 cases of hemorrhagic change .[Conclusion] Senile hemorrhagic cerebrovascular disease is easy to be misdiagnosed as epilepsy ,peptic ulcer hemorrhage and hypertensive encephalopathy .But head CT examination can diagnose it effectively .