Timing Problems in the Diagnosis and Treatment of Subarachnoid Hemorrhage
I believe we should refer briefly to the symptomatology and discuss the necessary diagnostic measures. Obviously there are differences of opinion here. The subarachnoid hemorrhage in the clinical state grade one is often mistaken. In our patient material for example these patients were thought to have neck-shoulder-syndrome, migraine, intoxication or botulism. We all know of cases where such a diagnostic error was fatal because of the subsequent recurrent hemorrhage. The question arises as to whether all these patients should have a lumbar puncture. Of course, the answer is no. However, I would say that such a procedure is indicated in all cases where acute headache is accompanied by vomiting. Furthermore the lumbar puncture should be drawn into consideration in all cases where a second attack occurs within several minutes or several hours, even if there is no loss of consciousness. Now I would like to ask Dr. BUSHE about the further procedure when the diagnosis of a subarachnoid hemorrhage is certain.
KeywordsSubarachnoid Hemorrhage Lumbar Puncture Early Operation Recurrent Hemorrhage Nuchal Rigidity
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