自发性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)临床表现不典型时,易发生误诊、延误病情,甚至危及生命。现结合我院1987～1997年误诊31例SAH讨论如下。 1 临床资料 1.1 一般资料 31例中男19例,女12例。年龄:最大73岁,最小18岁,平均58岁,其中>60岁21例,占67％,31例中患高血压病15例,糖尿病4例,SAH史2例,脑血管病史6例,冠心病4例,动态起病22例,占71％,静态起病9例,占29％。 31例最后均腰穿证实SAH,其中CT证实25例,并发现脑梗塞2例,SAH血肿形成1例。 1.2 临床表现首发症状 SAH的首发症状主要是突然起病的头痛、恶心、呕吐,本组首发症状两种以上同时出现23例,头痛、恶心、呕吐为最多。以单一症状出现8例,多为单纯性头痛、头昏、眩晕、意识障碍、抽搐为主2例,以头昏、眩晕为主4例,以肢体活动不灵活、麻木为主2例,其中多伴有很轻的头痛、恶心常 Spontaneous subarachnoid hemorrhage (SAH) atypical clinical manifestations, prone to misdiagnosis, delay the disease, and even life-threatening. Now combined with our hospital from 1987 to 1997 misdiagnosed 31 cases of SAH discussed below. 1 Clinical data 1.1 General Information 31 cases of male 19 cases, 12 females. Age: the largest 73 years old, the youngest 18 years old, average 58 years old, of which> 60 years 21 cases, accounting for 67%, 31 cases of hypertension in 15 cases, 4 cases of diabetes, SAH history in 2 cases, Coronary heart disease in 4 cases, 22 cases of dynamic onset, accounting for 71%, 9 cases of static onset, accounting for 29%. Twenty-one patients were proved to have SAH by final lumbar puncture, of which 25 were confirmed by CT, 2 were found cerebral infarction and 1 was SAH hematoma. 1.2 The first symptom of clinical manifestations The first symptom of SAH is the sudden onset of headache, nausea and vomiting, the group more than two of the first symptom at the same time there were 23 cases of headache, nausea and vomiting. There were 8 cases with single symptom, mostly simple headache, dizziness, dizziness, disturbance of consciousness and twitch, 2 cases were dizzy and dizzy, 4 cases were mainly dizzy and numbness, 2 cases More with a very light headache, nausea often