最后审阅: 14 四月 2021
最后更新: 11 二月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 突发剧烈头痛
  • 意识水平低下/意识丧失
  • 颈部僵硬和肌肉疼痛(假性脑膜炎
  • 危险因素
  • 眼睑下垂、复视伴瞳孔散大、眼眶疼痛

其他诊断因素

  • 畏光
  • 恶心/呕吐
  • 意识模糊
  • 先兆性头痛既往史
  • 癫痫发作
  • 复视
  • 视力丧失
  • 激越
  • 局灶神经系统功能障碍

危险因素

  • 高血压
  • 吸烟
  • 饮酒
  • 使用可卡因
  • 家族史
  • 马方综合征
  • Ehlers-Danlos 综合征
  • 弹性纤维假黄瘤
  • I 型神经纤维瘤病
  • 常染色体显性遗传型多囊肾病 (ADPKD)

诊断性检查

首要检查

  • 头颅 CT 平扫
  • 全血细胞计数 (FBC
  • 血清电解质
  • 凝血功能检查
  • 肌钙蛋白 I
  • 血清葡萄糖
  • 心电图(ECG

需考虑的检查

  • 腰椎穿刺术 (LP)
  • CT 血管造影 (CTA)
  • 磁共振血管成像 (MRA)
  • 数字减影血管造影 (DSA)
  • 脑电图 (EEG)

治疗流程

撰稿人

Consultant Neurologist

Greater Manchester Neurosciences Centre

Salford Royal Foundation Trust

Honorary Senior Lecturer

University of Manchester

Manchester

UK

利益声明

MJ declares that he has no competing interests.

Neurology Registrar

Manchester Centre for Clinical Neurosciences

Manchester

UK

利益声明

RP has been sponsored by Novartis to attend the International Headache Conference.

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Salah Keyrouz MD, FAHA

Associate Professor

Neurology and Neurosurgery

Washington University School of Medicine

St. Louis

MO

利益声明

SK is an author of a reference cited in this topic.

同行评议者展开全部内容

Professor of Emergency Medicine

Barts Health NHS Trust

London

UK

利益声明

Consultant Neurosurgeon

University Hospital Southampton NHS Foundation Trust

Southampton

Hampshire

UK

利益声明

DB is the chief investigator for the 'SFX-01 after SAH' trial sponsored by Evgen Pharma. He receives no payment from and has no financial interest in Evgen Pharma.

Registrar

University Hospital Southampton NHS Foundation Trust

Southampton

Hampshire

UK

利益声明

NB declares that he has no competing interests.

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Head of Research and Development, BMJ

利益声明

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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