Читать книгу Neurology - Charles H. Clarke - Страница 133

Drawing together data is essential. To conclude that a fall with loss of consciousness and residual weakness is ‘collapse?cause’ or a hemiparesis is ‘a CVA’ are not formulations any doctor should reach. Tease out the history and build on the signs found, to reach either a diagnosis or at least a direction for investigations. Such attention to detail can be hard in an emergency, but it is in acute neurology that many mistakes occur. For example, a sudden headache can be discounted when the reality is a subarachnoid haemorrhage, whereas thoughtful appraisal usually provides the correct answer. Another common error is the distinction between a seizure and syncope; epilepsy is overdiagnosed. It is sometimes taxing to formulate a diagnosis, but essential to try.