Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma
Objective This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development. Background Although SIH is more prevalent than expected and causes potentially life‐threatening complications including subdural hematoma (SDH)...
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| Veröffentlicht in: | Headache 2017-11, Vol.57 (10), p.1593-1600 |
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| creator | Kim, Youn‐Jung Cho, Hyun‐Young Seo, Dong‐Woo Sohn, Chang Hwan Ahn, Shin Lee, Yoon‐Seon Kim, Won Young Lim, Kyung Soo |
| description | Objective
This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development.
Background
Although SIH is more prevalent than expected and causes potentially life‐threatening complications including subdural hematoma (SDH), the association between misdiagnosis of SIH and SDH development is not yet evaluated.
Methods
Retrospective observational study was conducted between January 1, 2005, and December 31, 2014. Adult patients with spontaneous intracranial hypotension (age ≥ 18 years) were enrolled.
Results
Of the 128 patients with SIH, 111 (86.7%) were in no SDH group and 17 (13.3%) were in SDH group. Their clinical presentation did not show significant different between the two groups, except age, the days from symptom onset to correct diagnosis, and the number of misdiagnoses. Age (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07‐1.23) and the number of times SIH was misdiagnosed (OR, 1.82; 95% CI, 1.03‐3.21) were independent risk factors for the development of SDH in SIH patients by multivariate logistic analysis. The clinical outcomes, including length of hospital stay and revisit rate, were similar in the two groups.
Conclusions
The number of times SIH was misdiagnosed was associated with the later development of SDH perhaps because of delay in correct diagnosis of SIH. Clinicians would prevent the later complication of SDH in SIH patients by increasing the awareness and a high index of suspicion of SIH. |
| doi_str_mv | 10.1111/head.13132 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1914290097</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1962090821</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4232-97d2ec851ea75eb7eaff0fbddb368d5795413ab68dbe628bb67d69e1253ac5473</originalsourceid><addsrcrecordid>eNp90MtKxDAUBuAgio6XjQ8gATciVHNp0nYp4-gIiuDoykU5aVKNts2YtMi8va0dXbgwEJLFx885P0KHlJzR_py_GtBnlFPONtCECiajWFKyiSaE0CRKkzjdQbshvBFCYpnJbbTDUil4zMkEPd_ZoC28NC7YgF2JF0vXtNAY1wV807QeCg-NhQrPV0vXmiZY12AIGPCDDe_4CorWeVz2d9Ep3flBmhpaV8M-2iqhCuZg_e6hp6vZ43Qe3d5f30wvbqMiZpxFWaKZKVJBDSTCqMRAWZJSaa24TLVIMhFTDqr_KyNZqpRMtMwMZYJDIeKE76GTMXfp3UdnQpvXNhSmqsY1cprRmGWEZAM9_kPfXOebfrpeSUYykjLaq9NRFd6F4E2ZL72twa9ySvKh8nyoPP-uvMdH68hO1Ub_0p-Oe0BH8Gkrs_onKp_PLi7H0C-TZYuO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1962090821</pqid></control><display><type>article</type><title>Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Youn‐Jung ; Cho, Hyun‐Young ; Seo, Dong‐Woo ; Sohn, Chang Hwan ; Ahn, Shin ; Lee, Yoon‐Seon ; Kim, Won Young ; Lim, Kyung Soo</creator><creatorcontrib>Kim, Youn‐Jung ; Cho, Hyun‐Young ; Seo, Dong‐Woo ; Sohn, Chang Hwan ; Ahn, Shin ; Lee, Yoon‐Seon ; Kim, Won Young ; Lim, Kyung Soo</creatorcontrib><description>Objective
This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development.
Background
Although SIH is more prevalent than expected and causes potentially life‐threatening complications including subdural hematoma (SDH), the association between misdiagnosis of SIH and SDH development is not yet evaluated.
Methods
Retrospective observational study was conducted between January 1, 2005, and December 31, 2014. Adult patients with spontaneous intracranial hypotension (age ≥ 18 years) were enrolled.
Results
Of the 128 patients with SIH, 111 (86.7%) were in no SDH group and 17 (13.3%) were in SDH group. Their clinical presentation did not show significant different between the two groups, except age, the days from symptom onset to correct diagnosis, and the number of misdiagnoses. Age (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07‐1.23) and the number of times SIH was misdiagnosed (OR, 1.82; 95% CI, 1.03‐3.21) were independent risk factors for the development of SDH in SIH patients by multivariate logistic analysis. The clinical outcomes, including length of hospital stay and revisit rate, were similar in the two groups.
Conclusions
The number of times SIH was misdiagnosed was associated with the later development of SDH perhaps because of delay in correct diagnosis of SIH. Clinicians would prevent the later complication of SDH in SIH patients by increasing the awareness and a high index of suspicion of SIH.</description><identifier>ISSN: 0017-8748</identifier><identifier>EISSN: 1526-4610</identifier><identifier>DOI: 10.1111/head.13132</identifier><identifier>PMID: 28653430</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age ; Age Factors ; Blood ; Brain ; Complications ; Confidence intervals ; Diagnosis ; Diagnostic Errors ; Dura mater ; emergency department ; Female ; Hematoma ; Hematoma, Subdural - epidemiology ; Hematoma, Subdural - etiology ; Hematoma, Subdural - physiopathology ; Hematoma, Subdural - therapy ; Humans ; Hypotension ; Intracranial Hypotension - complications ; Intracranial Hypotension - diagnosis ; Intracranial Hypotension - epidemiology ; Intracranial Hypotension - therapy ; Length of Stay ; Logistic Models ; Male ; Meninges ; Middle Aged ; misdiagnosis ; Multivariate Analysis ; Odds Ratio ; Patient Readmission ; Patients ; Retrospective Studies ; Risk analysis ; Risk Factors ; spontaneous intracranial hypotension ; subdural hematoma ; Time Factors</subject><ispartof>Headache, 2017-11, Vol.57 (10), p.1593-1600</ispartof><rights>2017 American Headache Society</rights><rights>2017 American Headache Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4232-97d2ec851ea75eb7eaff0fbddb368d5795413ab68dbe628bb67d69e1253ac5473</citedby><cites>FETCH-LOGICAL-c4232-97d2ec851ea75eb7eaff0fbddb368d5795413ab68dbe628bb67d69e1253ac5473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhead.13132$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhead.13132$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28653430$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Youn‐Jung</creatorcontrib><creatorcontrib>Cho, Hyun‐Young</creatorcontrib><creatorcontrib>Seo, Dong‐Woo</creatorcontrib><creatorcontrib>Sohn, Chang Hwan</creatorcontrib><creatorcontrib>Ahn, Shin</creatorcontrib><creatorcontrib>Lee, Yoon‐Seon</creatorcontrib><creatorcontrib>Kim, Won Young</creatorcontrib><creatorcontrib>Lim, Kyung Soo</creatorcontrib><title>Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma</title><title>Headache</title><addtitle>Headache</addtitle><description>Objective
This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development.
Background
Although SIH is more prevalent than expected and causes potentially life‐threatening complications including subdural hematoma (SDH), the association between misdiagnosis of SIH and SDH development is not yet evaluated.
Methods
Retrospective observational study was conducted between January 1, 2005, and December 31, 2014. Adult patients with spontaneous intracranial hypotension (age ≥ 18 years) were enrolled.
Results
Of the 128 patients with SIH, 111 (86.7%) were in no SDH group and 17 (13.3%) were in SDH group. Their clinical presentation did not show significant different between the two groups, except age, the days from symptom onset to correct diagnosis, and the number of misdiagnoses. Age (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07‐1.23) and the number of times SIH was misdiagnosed (OR, 1.82; 95% CI, 1.03‐3.21) were independent risk factors for the development of SDH in SIH patients by multivariate logistic analysis. The clinical outcomes, including length of hospital stay and revisit rate, were similar in the two groups.
Conclusions
The number of times SIH was misdiagnosed was associated with the later development of SDH perhaps because of delay in correct diagnosis of SIH. Clinicians would prevent the later complication of SDH in SIH patients by increasing the awareness and a high index of suspicion of SIH.</description><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Blood</subject><subject>Brain</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Diagnostic Errors</subject><subject>Dura mater</subject><subject>emergency department</subject><subject>Female</subject><subject>Hematoma</subject><subject>Hematoma, Subdural - epidemiology</subject><subject>Hematoma, Subdural - etiology</subject><subject>Hematoma, Subdural - physiopathology</subject><subject>Hematoma, Subdural - therapy</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Intracranial Hypotension - complications</subject><subject>Intracranial Hypotension - diagnosis</subject><subject>Intracranial Hypotension - epidemiology</subject><subject>Intracranial Hypotension - therapy</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Meninges</subject><subject>Middle Aged</subject><subject>misdiagnosis</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Patient Readmission</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>spontaneous intracranial hypotension</subject><subject>subdural hematoma</subject><subject>Time Factors</subject><issn>0017-8748</issn><issn>1526-4610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90MtKxDAUBuAgio6XjQ8gATciVHNp0nYp4-gIiuDoykU5aVKNts2YtMi8va0dXbgwEJLFx885P0KHlJzR_py_GtBnlFPONtCECiajWFKyiSaE0CRKkzjdQbshvBFCYpnJbbTDUil4zMkEPd_ZoC28NC7YgF2JF0vXtNAY1wV807QeCg-NhQrPV0vXmiZY12AIGPCDDe_4CorWeVz2d9Ep3flBmhpaV8M-2iqhCuZg_e6hp6vZ43Qe3d5f30wvbqMiZpxFWaKZKVJBDSTCqMRAWZJSaa24TLVIMhFTDqr_KyNZqpRMtMwMZYJDIeKE76GTMXfp3UdnQpvXNhSmqsY1cprRmGWEZAM9_kPfXOebfrpeSUYykjLaq9NRFd6F4E2ZL72twa9ySvKh8nyoPP-uvMdH68hO1Ub_0p-Oe0BH8Gkrs_onKp_PLi7H0C-TZYuO</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Kim, Youn‐Jung</creator><creator>Cho, Hyun‐Young</creator><creator>Seo, Dong‐Woo</creator><creator>Sohn, Chang Hwan</creator><creator>Ahn, Shin</creator><creator>Lee, Yoon‐Seon</creator><creator>Kim, Won Young</creator><creator>Lim, Kyung Soo</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma</title><author>Kim, Youn‐Jung ; Cho, Hyun‐Young ; Seo, Dong‐Woo ; Sohn, Chang Hwan ; Ahn, Shin ; Lee, Yoon‐Seon ; Kim, Won Young ; Lim, Kyung Soo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4232-97d2ec851ea75eb7eaff0fbddb368d5795413ab68dbe628bb67d69e1253ac5473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Blood</topic><topic>Brain</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Diagnostic Errors</topic><topic>Dura mater</topic><topic>emergency department</topic><topic>Female</topic><topic>Hematoma</topic><topic>Hematoma, Subdural - epidemiology</topic><topic>Hematoma, Subdural - etiology</topic><topic>Hematoma, Subdural - physiopathology</topic><topic>Hematoma, Subdural - therapy</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Intracranial Hypotension - complications</topic><topic>Intracranial Hypotension - diagnosis</topic><topic>Intracranial Hypotension - epidemiology</topic><topic>Intracranial Hypotension - therapy</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Meninges</topic><topic>Middle Aged</topic><topic>misdiagnosis</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Patient Readmission</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>spontaneous intracranial hypotension</topic><topic>subdural hematoma</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Youn‐Jung</creatorcontrib><creatorcontrib>Cho, Hyun‐Young</creatorcontrib><creatorcontrib>Seo, Dong‐Woo</creatorcontrib><creatorcontrib>Sohn, Chang Hwan</creatorcontrib><creatorcontrib>Ahn, Shin</creatorcontrib><creatorcontrib>Lee, Yoon‐Seon</creatorcontrib><creatorcontrib>Kim, Won Young</creatorcontrib><creatorcontrib>Lim, Kyung Soo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Headache</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Youn‐Jung</au><au>Cho, Hyun‐Young</au><au>Seo, Dong‐Woo</au><au>Sohn, Chang Hwan</au><au>Ahn, Shin</au><au>Lee, Yoon‐Seon</au><au>Kim, Won Young</au><au>Lim, Kyung Soo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma</atitle><jtitle>Headache</jtitle><addtitle>Headache</addtitle><date>2017-11</date><risdate>2017</risdate><volume>57</volume><issue>10</issue><spage>1593</spage><epage>1600</epage><pages>1593-1600</pages><issn>0017-8748</issn><eissn>1526-4610</eissn><abstract>Objective
This study aimed to evaluate the association between misdiagnosis of spontaneous intracranial hypotension (SIH) and subdural hematoma development.
Background
Although SIH is more prevalent than expected and causes potentially life‐threatening complications including subdural hematoma (SDH), the association between misdiagnosis of SIH and SDH development is not yet evaluated.
Methods
Retrospective observational study was conducted between January 1, 2005, and December 31, 2014. Adult patients with spontaneous intracranial hypotension (age ≥ 18 years) were enrolled.
Results
Of the 128 patients with SIH, 111 (86.7%) were in no SDH group and 17 (13.3%) were in SDH group. Their clinical presentation did not show significant different between the two groups, except age, the days from symptom onset to correct diagnosis, and the number of misdiagnoses. Age (odds ratio [OR], 1.15; 95% confidence interval [CI], 1.07‐1.23) and the number of times SIH was misdiagnosed (OR, 1.82; 95% CI, 1.03‐3.21) were independent risk factors for the development of SDH in SIH patients by multivariate logistic analysis. The clinical outcomes, including length of hospital stay and revisit rate, were similar in the two groups.
Conclusions
The number of times SIH was misdiagnosed was associated with the later development of SDH perhaps because of delay in correct diagnosis of SIH. Clinicians would prevent the later complication of SDH in SIH patients by increasing the awareness and a high index of suspicion of SIH.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28653430</pmid><doi>10.1111/head.13132</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Age Age Factors Blood Brain Complications Confidence intervals Diagnosis Diagnostic Errors Dura mater emergency department Female Hematoma Hematoma, Subdural - epidemiology Hematoma, Subdural - etiology Hematoma, Subdural - physiopathology Hematoma, Subdural - therapy Humans Hypotension Intracranial Hypotension - complications Intracranial Hypotension - diagnosis Intracranial Hypotension - epidemiology Intracranial Hypotension - therapy Length of Stay Logistic Models Male Meninges Middle Aged misdiagnosis Multivariate Analysis Odds Ratio Patient Readmission Patients Retrospective Studies Risk analysis Risk Factors spontaneous intracranial hypotension subdural hematoma Time Factors |
| title | Misdiagnosis of Spontaneous Intracranial Hypotension as a Risk Factor for Subdural Hematoma |
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