Subarachnoid Hemorrhage - Malpractice Lawyers Compensation Claim

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Subarachnoid Hemorrhage - Medical Malpractice

A subarachnoid haemorrhage represents bleeding within the subarachnoid space of the brain. This is the space between the brain and the covering over the brain. Bleeding from a subarachnoid haemorrhage is especially dangerous because the bleeding is usually fairly fast and doctors can't get a hold of the bleeding before it causes a severe mass effect and herniation of the brain, which is fatal. Subarachnoid haemorrhages can be caused by bleeding disorders, being on blood thinners, trauma to the brain, arteriovenous malformations, cerebral aneurysms or unknown causes. The blood vessels are usually quite fragile and can break down easily.

When a fall causes the subarachnoid haemorrhage, it is commonly in the elderly who fall and hit their head. Motor vehicle accidents cause subarachnoid haemorrhages in younger people. The incidence of this type of haemorrhage is about 10 to 15 individuals out of ten thousand people. The usual age range for subarachnoid haemorrhage is about 20 to 60 years of age.

There are several risk factors for subarachnoid haemorrhage, including cerebral aneurysms, having a connective tissue disease or fibromuscular dysplasia that affects the strength of the blood vessels, having high blood pressure or having a smoking history or polycystic kidney disease. If you have a strong family history of aneurysms, you should be evaluated before you actually get a haemorrhage from an aneurysm.

The symptoms of a subarachnoid haemorrhage are the sudden onset of severe headache that is usually worse at the top or back of the head. It is often described as the worst headache of your life. A popping sound can be heard in the head in certain cases and there can be a sudden loss of consciousness as the bleeding is profound. You can have paralysis, confusion, irritability, loss of feeling, neck and shoulder pain, seizures, vomiting, nausea, photophobia or double vision. There can be a difference in pupil size and many can have a stiff neck or a stiff back.

The diagnosis of subarachnoid haemorrhage can be done using a complete history and neurological examination. The Glasgow coma scale can best tell the degree of involvement of the brain and the level of consciousness. Look for an uneven pupil. A CT scan of the brain can show blood in the subarachnoid space and a spinal tap can look for blood or red blood cells in the cerebrospinal fluid. A CT angiography can be done to see where the leakage is located so the neurosurgeon can find out where to stop the bleeding during subsequent surgery. An ultrasound can show where the subarachnoid haemorrhage is located and can be somewhat helpful in an emergency situation.

Treatment is designed to stop the bleeding fast enough to prevent herniation and death of the patient. The treatment must be given promptly as the bleeding tends to be fast. A burr hole is used to drain blood from the subarachnoid space if at all possible and the surgeon works fast to clip any bleeding aneurysm. The doctor does this using a craniotomy, which opens a part of the skull to get at the aneurysm or arteriovenous malformation. There is a procedure known as an endovascular coiling technique in which a wire is put into the aneurysm and coiled in order to stop the bleeding within the aneurysm. The blood clots within the aneurysm and the haemorrhaging stops. It is a less invasive way of stopping the bleeding of an aneurysm.

The coma must be managed in a subarachnoid haemorrhage. This might involve oxygen and intubation of the patient so that they can breathe. There may be burr holes or drainage tubes placed within the brain in order to let the blood flow out and not build up within the brain. There should be strict bed rest so that the patient does not worsen the bleeding. It keeps the blood pressure down as well. Medications to lower the blood pressure might need to be given to slow the bleeding process. Calcium channel blockers are used as medications that lessen the surrounding blood vessel spasms.

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