INVESTIGATION INTO THE CAUSES OF DELAYED DIAGNOSIS OF SUBARACHNOID HEMORRHAGE

To analyze the factors that could influence early diagnosis and referral of subarachnoid hemorrhage (SAH), demographic, clinical and neuroradiological data of 112 cases of SAH admitted from January 1985 to December 1987 to our departments was compared between patients admitted in the first 24 h of onset (group 1, 56 patients), between the 1st and the 4th day (group 2, 33 patients) and after the 4th day (group 3, 23 patients). The main cause of delayed referral was diagnostic failure of SAH (70% of the cases). Depressed consciousness and meningeal signs were the only findings contributing to early referral. Improving physicians' ability to recognize the clinical presentation of SAH is essential to reduce delayed admission and make early intervention measures available to the majority of SAH patients.