本文分析了脑转移为首发症状的肺癌24例。多数患者因颅内高压、精神异常、肢体麻木无力及颅神经损害就诊,而呼吸道症状不明显。误诊率达83.3%,误诊原因为对肺癌脑转移认识不足,警惕性不高。作者强调对有神经系统症状的中老年人必须进行全面检查以避免肺癌脑转移的误(漏)诊。 This article analyzed 24 cases of lung cancer with brain metastases as the first symptom. Most patients were diagnosed with intracranial hypertension, mental disorders, limb numbness, and cranial nerve damage, while respiratory symptoms were not evident. The rate of misdiagnosis was 83.3%. The reason for misdiagnosis was insufficient understanding of brain metastases from lung cancer, and its alertness was not high. The authors stress that the middle-aged and elderly people with neurological symptoms must undergo a thorough examination to avoid misdiagnosis (leakage) of brain metastases from lung cancer.