Subdural Haematoma - Malpractice Lawyer Compensation Claim

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Subdural Haematoma - Medical Malpractice

A subdural haematoma or haemorrhage is a severe collection of blood that builds up underneath the dura of the brain. The dura is a tough fibrous covering over the brain and spinal cord. A subdural haemorrhage can be termed acute, subacute and chronic. Acute subdural haematomas are extremely serious because of a great amount of bleeding occurring very quickly so that pressure builds up in the brain and a herniation can occur, which results in death. Brain herniation is when the brain pushes through the large foramen at the base of the skull and permanently damages the breathing centers of the brain and you stop breathing.

Particularly in the elderly, a small trauma can cause a subdural haematoma. There can be few or no symptoms for several days, resulting in a subacute subdural haematoma. There can be many weeks or months without obvious symptoms other than a headache or increasing dementia, called a chronic subdural haematoma.

The bleeding of a subdural haematoma happens when small veins between the brain's surface and the dura or lining of the brain get broken. When they tear, they can lead to rapid bleeding between the brain and the dura or the bleeding can be minor, resulting in subacute or chronic injury. In the elderly, the brain is relatively shrunken so the veins are already stretched and break easily. In rare situations, the subdural haemorrhage can happen without any injury at all and is called idiopathic subdural haematoma.

You have a greater risk of getting a subdural haematoma if you are on blood thinners, have some type of disability that results in falls, abuse alcohol chronically, or engage in sports or other activities that can cause head trauma, whether single head traumas or repetitive head traumas. The very young or the very old are at risk for subdural haematomas.

The symptoms of a subdural haematoma include a severe headache, difficulties in balance, speech slurring, confusion, lethargy nausea, vomiting, coma or loss of consciousness, seizures that didn't exist before, double vision, weakness or changes in vision. You can have weakness on a part of the body or numbness or a part of the body. Stroke-like symptoms are not out of the question. Children and adults have these symptoms while infants have different symptoms. Infants can have problems feeding, seizures which can be generalized or focal, a bulging of the fontanelles (soft spots), weakness, a high pitched cry, vomiting, irritability or separation of the sutures of the skull.

Subdural haematomas are medical emergencies that require immediate neurological and neurosurgical intervention. Doctors need to do a CT scan or MRI scan of the head to see where the brain is bleeding and how much pressure is on the brain. CT scans are better tests because blood shows up easily on this type of scan. CT scans can show imminent herniation as well and this means that emergency surgery to decompress the brain is necessary. A burr hole can be made into the skull to let the blood drain out very quickly. A craniotomy or open brain surgery can be done to stop the bleeding and fix the problem easier. When a craniotomy is done, the skull cap or a portion thereof is removed, the work is done and the skull piece is replaced back on the brain in order to heal.

Medications are also used to treat subdural haematomas. Steroids shrink swelling and inflammation of the brain. Mannitol is used to decrease the amount of excess liquid in the brain so the swelling is reduced. Medications are given to control seizures, particularly Dilantin or phenytoin.

There are many complications of subdural haematomas, including brain herniation, which is almost always fatal. Chronic seizures or epilepsy are a result of having a subdural haematoma. Permanent weakness or stroke-like symptoms can be secondary to having a subdural haematoma. It all depends on how big the subdural haematoma is and where it is located on the skull. Subdurals that are treated promptly do better than those in which the haematoma is delayed.

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