Subarachnoid Hemorrhage - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
Our medical malpractice lawyers deal with Subarachnoid Hemorrhage negligence cases. If you would like legal advice at no cost and with no further obligation just call the helpline or complete the contact form or email our lawyers offices. Our Subarachnoid Hemorrhage medical malpractice lawyers usually deal with personal injury compensation cases on a contingency basis which means that you only pay your lawyers legal fees if the case is won.
A brain aneurysm is a weak bulging area in a cerebral artery, usually caused naturally by wear and tear of the walls of the blood vessel, which may eventually lead to a rupture and subsequent bleeding. Rupture of the artery at the location of a brain aneurysm often occurs at a time of physical effort such as coughing, going to the toilet, heavy lifting or during sexual activity. Whilst the root cause of a brain aneurysm is usually a natural phenomena, subsequent identification of an ensuing subarachnoid hemorrhage and failure to properly treat the condition may amount to medical malpractice.
A subarachnoid haemorrhage (SAH) is a traumatic brain injury (TBI) that occurs when a blood vessel running under the arachnoid mater bursts over the surface of the brain.
Subarachnoid: means under the arachnoid mater
Hemorrhage: denotes a bleed (commonly called a hematology)
A subarachnoid hemorrhage is the leaking of blood from a blood vessel under the arachnoid membrane.
The arachnoid mater is a “web-like” covering, which makes up the middle layer of the three meninges that cover the brain.
The subarachnoid hemorrhage is a reasonably uncommon form of brain hemorrhage, but, when it does occur, the most common outcome is death, especially in the elderly.
The bleeding can stop at any time and it will often seal and heal itself. However, there is a high risk of re-occurrence, especially if uncontrolled high blood pressure is present.
Causes and Symptoms
The most common cause of subarachnoid hemorrhages is a weakness in the blood vessels in the brain. When one or more of the capillaries and veins feeding the brain become stretched in a certain area, the resulting bulge is called an “aneurysm”. When the aneurysm bursts into a full-blown hemorrhage, the situation becomes life threatening.
The symptoms are very like those of most other brain hemorrhage conditions and include :
- A sudden and severe headache – often described as similar to a thunderclap.
- A very stiff neck, which restricts head movement.
- Sickness or vomiting.
- Garbled speech.
- Rapid changes in mood.
Sometimes this type of brain hemorrhage is difficult to pinpoint because the symptoms are very akin to meningitis (infection of the meninges), but without the signs of fever and/or rashes associated with meningitis.
The subarachnoid hemorrhage can often be diagnosed by the characteristic symptoms of a stiff neck and a sudden severe headache, but the severity of the hemorrhage and possible course of action to be taken is usually undertaken after the details are clearer. This is done via one or more of the following scans :
- An MRI (magnetic resonance imaging) scan is the most frequently used diagnosis procedure.
- A CT (computed tomography) scan can also provide useful information.
- The Doppler scan, which employs ultrasound to uncover sudden variation in the flow of blood in order to determine where the bleeding has occurred, is also utilized.
Misdiagnosis or late diagnosis of a subarachnoid hemorrhage can give rise to a medical malpractice compensation claim.
Further consequences of a subarachnoid hemorrhage include other veins surrounding the burst vein going into seizure. This can precipitate further blood loss as the convulsing veins push more blood out of the breached vessel, causing further damage to the blood supply and brain damage.
To prevent this situation, a drug called nimodipine (an anti-spasm medication) is usually administered for several weeks. Also, a strong acetaminophen will lessen headaches.
The use of neurosurgical clips is another possibility. A neurosurgeon opens a small section of the skull and clamps the leaking blood vessel shut with a small metal clip.
A less invasive method is Endovascular coiling. It involves inserting a thin plastic tube into the artery in the groin. This tiny tube is guided into the leaking blood vessel and minute platinum spirals are put into place to stem the flow of blood leaking from the blood vessel.
Negligent Treatment of a subarachnoid hemorrhage can give rise to a medical malpractice compensation claim.
Recovery from a subarachnoid hemorrhage will depend on:
- The acuteness of the hemorrhage.
- The site of the hemorrhage.
- The speed of medical intervention.
Improvement can be erratic, with episodes of emotional upheaval, tiredness, sleeplessness, headaches, random loss of feeling and sensory changes in sight, hearing, smell, taste and touch.
Lifestyle changes which can be adopted are giving up smoking and drinking alcohol to excess, control of high blood pressure and avoiding high salt and high fat foods.
There are many contributing risk factors that have been identified to the cause of a brain aneurysm which include smoking, hypertension and traumatic head injury. The condition may show hereditary tendencies and is associated with Ehler’s Syndrome, Polycystic Kidney Disease and Mar fan’s Syndrome. More than 2,000 people suffer from a subarachnoid hemorrhage in Canada each year, many with fatal consequences.
Emergency Room Errors
Most people who suffer from the symptoms of a subarachnoid hemorrhage are usually taken to the emergency room of their local hospital however diagnosis is not always straightforward and patients are frequently sent home without further treatment only to become the victim of a damaging or fatal bleed some hours later. Emergency room doctors should be aware of the warning signs that precede a major bleed in the brain and should not ignore relatively minor symptoms which occur in about 50% of all patients. Failure to recognize the warning signs and give appropriate medical advice and treatment may be medical malpractice. The symptoms of a ruptured blood vessel in the brain include:
- severe localized headache
- collapse and unconsciousness
- stiff neck or neck pain
- nausea and vomiting
- blurred vision or double vision
- dilated pupils
- pain above and behind the eye
- loss of sensation
- sensitivity to light
There is a further area of potential negligence that needs to be considered which relates to treatment following accurate diagnosis of a brain hemorrhage, subsequent to admission to a hospital. It is frequently necessary to carry out intra-cranial surgery whereby the blood vessels are clipped or sealed. This surgery is difficult and challenging and only the most experienced neurosurgeons should carry out this operation. Any errors made at this stage may also give rise to a claim for damages for medical malpractice if the outcome of the operation is less satisfactory than it should have been.
Medical Malpractice Lawyer
In view of the serious nature of a brain hemorrhage, whereby over 50% of people die within minutes of hemorrhaging with a high proportion of the remainder subsequently suffering fatal consequences whilst many of the survivors have serious long term deficits, damages and compensation can be substantial. We ensure that there is no guesswork in the choice of your lawyer and that your claim is handled by a medical malpractice expert. Your compensation claim will be dealt with on a contingency fees basis which means that your subarachnoid hemorrhage lawyer will not get paid unless he achieves settlement on your behalf. If you would like legal advice at no cost without obligation from a medical malpractice lawyer then just call the helpline or complete the contact form or email our offices. A medical malpractice lawyer will telephone you at the first possible opportunity.
Subarachnoid Hemorrhage Overview
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.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here