Brain Haemorrhage - Medical Negligence Solicitors
A brain haemorrhage is a type of bleeding that occurs inside the skull. It can be caused by traumatic injury or by a spontaneous bleed coming from an aneurysm or other type of broken blood vessel. There are other types of intracranial bleeds that are considered extra-axial. That is, they occur within the cranium or bony part of the brain but do not occur within the brain tissue itself. Examples of extra-axial haemorrhages include the subdural, epidural and subarachnoid haemorrhages. Brain haemorrhage compensation solicitors deal with applications for awards of damages for personal injury on the basis of medical negligence following either miss-diagnosis or failed surgical intervention both of which can cause a worsening of the initial problem.
The two main types of intra-axial haemorrhages include the intraparenchymal haemorrhage and the intraventricular haemorrhages. The intraventricular haemorrhages occur in the fluid-filled spaces of the brain tissue, while the intraparenchymal haemorrhages occur within the actual brain tissue. Both of these types of bleeds are considered to be strokes, albeit haemorrhagic strokes and both are considered a serious brain injury. The mortality rate for these kinds of haemorrhagic strokes is around forty percent.
Signs and Symptoms
The signs and symptoms of an intracranial haemorrhage vary somewhat with the area of the brain being affected by the haemorrhage. Symptoms are also related to the size of the area of bleeding. Symptoms can come on quite suddenly or can be gradual over time. Common symptoms include having the sudden onset of a severe headache associated with seizures. There can be visual changes, weakness or numbness in an arm or a leg, nausea, vomiting, problems with speech or in understanding speech, difficulty swallowing, hand tremors or difficulty with fine motor skills, coordination difficulty, balance problems, a funny taste in one’s mouth, and loss of consciousness or lethargy. There can be difficulty reading or writing. The severe headache is one of the most common symptoms so if you experience this symptom, especially with the other symptoms, you should call the emergency services.
Brain haemorrhage compensation claim solicitors often deal with cases where a patient in the early stages of a brain haemorrhage presents at hospital suffering from severe headache to be told to go home and take analgaesics. Within a few hours the patient is unconscious, often with little chance of full recovery which may have taken place with early surgical intervention. This scenario may be determined to be an issue of medical negligence leading to an award of damages for pain and suffering and financial losses.
Causes and Risk Factors
One of the biggest risk factors for an intracranial haemorrhage is high blood pressure, which increases the risk of a spontaneous bleed by 2-6 times. Trauma causing penetrating skull fractures or depressed skull fractures can predispose a person to getting an intracranial bleed. Traumatic injury that causes an acceleration and deceleration of the brain within the skull can cause an intracranial bleed. Having an aneurysm in the brain can cause an intracranial bleed. Having a tumor that bleeds is another cause of an intracranial bleed. Other risk factors include having diabetes, being in menopause, cigarette use and drinking more than two alcoholic drinks each day.
Intracranial haemorrhages account for 13 percent of strokes. Bleeding comes from one or more blood vessels and intersperses between brain cells. This causes brain swelling, which gives the headache and other symptoms. The blood pools into a hematoma or collection of blood and kills off nearby brain cells.
Rarer causes of intracranial haemorrhages include amyloid angiopathy, which is a blood vessel abnormality, bleeding disorders like hemophilia and sickle cell disease, liver disease and brain tumor.
Anytime there is the clinical suggestion of an intracerebral bleed, doctors do a CT scan of the head. Blood shines much brighter than brain tissue on the CT/X-ray scan and the bleed is easily identifiable. Any other problems, such as a brain tumor or depressed skull fracture can also be seen by CT scan.
Failure to diagnose and treat may be an issue of medical negligence whereby brain haemorrhage compensation claim solicitors can issue proceedings to claim damages for personal injury and loss.
Doctors must begin with a quick CT scan so they know whether or not surgery or medications will work to treat the haemorrhage. Medications include giving factor VIIa to slow down the bleeding and increase clotting. Giving a person medication to reduce blood pressure does a good job of keeping the bleeding to a minimum. Mannitol reduces the pressure within the brain. Pain medications are given to reduce the degree of headache.
If the person has a coagulopathy or bleeding disorder, doctors can give vitamin K, protamine, and fresh frozen plasma or platelet transfusions. Seizures are controlled with anticonvulsant medication. Antacids are given to prevent a bleeding stomach ulcer, a condition that is usually connected to intracerebral hemorrhages. Steroids, along with the blood pressure medications, help reduce the swelling.
Some patients need major support, such as intubation to help them breathe and IV fluids. If surgery is required, it means there is a structural lesion causing the bleed, such as an aneurysm or the hematoma has exceeded three centimeters in diameter. In such cases, doctors may put a catheter into the brain to close off or dilate blood vessels, which is a minimally invasive way of getting at the source of the bleeding. In addition, endoscopic or stereotactic surgery can aspirate the haematoma if the bleed happens to be in the basal ganglia. This approach may or may not work.
Inadequate surgical treatment may be an issue of medical negligence whereby brain haemorrhage compensation claim solicitors can issue proceedings to claim damages for personal injury and loss.
Traumatic brain haemorrhages are very serious, especially if the brain stem is involved. If the bleed involves the medulla oblongata, almost everyone dies because it affects the part of the brain that controls the vagus nerve, important in respiration and blood vessel circulation. The death rate is about 40 percent or between 34 and 50 percent after thirty days post hemorrhage. Half of all deaths from intracranial haemorrhages die within the first two days.
If a person survives a brain haemorrhage, there can be permanent brain damage. This can lead to permanent speech abnormalities, gait problems or memory issues. There can be the development of a seizure disorder because of damage to crucial parts of the brain. All of the complications of a brain haemorrhage are the same as the acute symptoms except that they don’t go away.
Brain haemorrhages can be prevented by not smoking, not using drugs that increase blood pressure (such as cocaine), treating high blood pressure, avoiding trauma by wearing a seat belt and protecting yourself from head injuries while cycling, preventing aneurysms before they bleed, and watching Coumadin levels if you happen to require Coumadin for a specific disease.
In considering strokes of all causes, an intracranial bleed is responsible for 20 percent of all strokes. This compares to 40 percent which are caused by cerebral thrombosis and 30 percent, which are caused by cerebral embolism. In Africans, the risk of cerebral hemorrhage is more than double that of Caucasians.
Medical Negligence Sollicitors
If you would like legal advice at no cost about claiming compensation for a brain haemorrhage just use the solicitors helpline, complete the contact form or email our lawyers solicitors offices and a specialist medical negligence solicitor will telephone you with no further obligation. Following a review of the circumstances of the injury and of the medical records you will be advised whether you have a reasonable claim and if so, what steps you should take to protect your legal right to receive compensation. All of our brain haemorrhage solicitors use no win no fee arrangements to represent their clients which means that if your brain haemorrhage solicitor doesn't achieve settlement then he doesn't get paid his professional costs and the client does not receive a bill for legal costs.
Our brain haemorrhage medical negligence solicitors have offices situated in Adelaide, Brisbane, Canberra, Melbourne, Perth, Darwin, and Sydney.
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Brain Haemorrhage Overview
A brain haemorrhage is a condition of the brain that leads to stroke-like symptoms as a result of localized bleeding to the surrounding brain tissues. The bleeding kills cells of the brain that don't like having blood around them. Brain haemorrhages can occur as a result of high blood pressure, trauma to the brain or to arteriovenous malformations-hereditary lesions found in the brain. Other names for brain haemorrhages include intracranial haemorrhages, cerebral haemorrhages or intracerebral haemorrhages. Such bleeding episodes happen about thirteen percent of the time with strokes.
So how does a brain haemorrhage occur? It happens when there is a defect in a blood vessel within the brain so that blood enters the tissue around the brain tissue. Blood around the brain tissue causes swelling of the brain tissue itself and the actual increase in space taken up by the blood results in a lack of space for normal brain tissue, which dies under the pressure. Blood flow to the vital tissues is obstructed, resulting in greater brain damage.
It's important to remember that bleeding can occur within the brain, between the membranes surrounding the brain and between the skull and the outer dura. All of these types of bleeding happen and can cause brain damage as a result.
Bleeding in the brain can be caused by several things including a head trauma, which is the most common reason a brain haemorrhage can occur in patients under the age of 50 years. High blood pressure can weaken the wall of the blood vessel to the point that it ruptures and bleeds. An aneurysm can be an area of weakness of the wall of the vasculature. Aneurysms can be something you are born with and which stay with you through life unless you are lucky enough to have them removed before they leak or rupture.
Amyloid angiopathy is an abnormal blood vessel occurring with age. The result of having multiple amyloid deposits is having many small bleeding spots within the blood vessels. Eventually, a large bleed can occur from within the vessel. Liver disease contributes to an increase in bleeding potential due to a lack of blood vessel clotting factors. Brain tumours can cause intracerebral bleeding. Bleeding disorders such as hemophilia and certain types of sickle cell disease can decrease the platelet count, resulting in excessive brain bleeding.
The symptoms of intracerebral or brain haemorrhage include sudden headache or a headache that happens over time. The headache can be centralized or can occur on one side of the brain or the other, depending on where the bleeding is. Seizures can happen without a previous history of seizures and there can be nausea and vomiting. Some people can have a weakness or numbness in an arm or leg or in one side of the body or another. There can be lethargy or decrease in alertness and changes in vision can occur. You can have speech deficits, difficulty with swallowing, loss of motor skills (large or small motor skills), difficulty reading or writing, loss of balance or coordination and an abnormal sense of taste. Loss of consciousness is common if the bleed is severe.
The treatment of a brain haemorrhage depends on how big the bleed is and on the symptoms you have. The doctor determines the size of the brain bleed by doing a CT scan or MRI scan of the head. This shines up blood in the lungs quite easily, showing the extent of the bleeding in three dimensions. An angiogram can locate the site of bleeding and can tell if there is active bleeding. A lumbar puncture can show if there is blood in the subarachnoid space and blood tests can show what clotting factors are present and what the platelet count is.
Treatment of the bleeding within the brain depends on whether or not the area can be reached by surgery. If it can, surgery is sometimes used to stop the bleeding. Medical treatments of a brain haemorrhage include using medications for pain, corticosteroids for brain swelling, and diuretics to reduce fluid on the body and brain. Anticonvulsant medications help to block the possibility of seizures. Sometimes platelets or clotting factors are replaced in order to stop bleeding.
Brain haemorrhages can be prevented by managing high blood pressure, stopping smoking, avoiding drugs like cocaine, which increases blood and brain pressure, driving safely and wearing a seat belt, wearing a helmet when necessary for riding machines and fixing aneurysms if they exist. If you take Coumadin, a blood thinner, you should try to avoid taking too much as this can cause excessive bleeding on the brain. If your condition has worsened because of medical negligence, contact our brain haemorrhage solicitors for advice at no cost.
Subarachnoid Haemorrhage Overview
A subarachnoid haemorrhage is a sudden leak of blood which spreads over the surface of the brain. The majority of these haemorrhages are caused as a result of a weakness in the wall of a blood vessel resulting in a rupture caused by the pressure of blood. Smokers with high blood pressure are at greatest risk. The injury is more common in older people however aneurysms do occur in young people with no obvious risk factors and it most often occurs at a time of physical effort such as coughing, going to the toilet, heavy lifting, or straining, or during sex. The initial symptom is often a sudden, severe headache which usually persists for more than an hour, often at the back of the head, which is followed by being sick. In severe cases a fit, collapse and loss of consciousness may occur. If you believe that your condition has arisen or been worsened as a result of medical negligence, contact our brain haemorrhage solicitors for advice at no cost.
Diagnosis is often difficult and patients may arrive at the hospital having suffered from a sudden, severe headache which may have cleared to leave them well, with no physical signs or at the other end of the spectrum the patient may be in a coma. Numerous warning symptoms may give an indication of a bleed in the brain however diagnosis is often missed by specialist consultants even though the warning symptoms prior to a major haemorrhage occur in about 50% of all patients. If a sub arachnoid haemorrhage does subsequently occur and causes physical injury or death that might have been avoided with proper diagnosis then the healthcare professionals involved in the initial treatment may have been negligent and liable to pay compensation for any medical negligence claims made against them. If you believe that your condition has worsened as a result of medical negligence, contact our brain haemorrhage solicitors for advice at no cost.
Subarachnoid haemorrhage involves bleeding in the space between the brain and the overlying subarachnoid lining. This space is known as the subarachnoid space. The bleeding can be very fast and can result in death within hours of getting the subarachnoid haemorrhage.
The cause of a subarachnoid bleed includes a bleeding disorder that causes spontaneous bleeding between the layers of the brain and connective tissue. It can also be caused by an arteriovenous malformation or from a cerebral aneurysm. Head injuries can disrupt blood vessels in the subarachnoid space. It can happen if you use blood thinners or happen just as a result of an idiopathic, non-traumatic bleed. The most common cause of a subarachnoid haemorrhage occurs in the elderly who have fallen and have struck their head during the fall. In the youth, the most common cause of subarachnoid bleeding is a motor vehicle accident.
Subarachnoid haemorrhage is not common. It occurs in 10-15 percent out of a thousand individuals and is due to a rupture of a cerebral aneurysm most commonly in those between the ages of 20-60. Women get the haemorrhage slightly more commonly than do men.
Risk factors to subarachnoid haemorrhage include having an aneurysm in other types of blood vessels, having fibromuscular dysplasia, which is a connective tissue disorder affecting the outside of walls of the blood vessels, having high blood pressure, smoking history or a history of polycystic kidneys. If you have a strong family history of aneurysms, your risk of bleeding from an aneurysm yourself is greater than average.
Symptoms of subarachnoid haemorrhage are usually severe and life threatening. People with a subarachnoid haemorrhage usually experience the "worst headache of their life", usually worse in the back of the head. There is usually a decreased level of consciousness associated with a loss of feeling or movement to a part of the body. There are personality changes and alterations in mood, including irritability and confusion. Muscle aches, including shoulder and neck pain, are also common along with nausea and vomiting. Seizures can happen and the individual can often not tolerate light. There is usually a stiff neck and double vision or vision problems.
Rarely, there can be differing sizes of pupils, eyelid drooping and arching of the back with subarachnoid haemorrhage.
Doctors need to diagnose a subarachnoid haemorrhage relatively quickly so as to proceed with treatment as soon as possible. A complete neurological examination and physical examination can show some of the symptoms as noted above. The patient can be in a deep coma. Neurological deficits can be noted on examination. A CT scan of the head will show blood in the subarachnoid space and pressure on the brain. There can be a spinal tap as well, which will show blood in the cerebrospinal fluid. A CT angiography exam can show the presence or absence of an aneurysm. CT angiography is the best test of a subarachnoid haemorrhage.
MRI scanning can show the same thing as a CT scan of the head and, in some cases, an ultrasound done through the skull can show blood vessel spasms and areas of bleeding.
The treatment of subarachnoid bleeding must be fast in order to save one's life. The idea is to save your life as well as to prevent brain damage as a result of pressure on the brain. Surgery may be required in order to clip off an aneurysm and prevent further bleeding. If this cannot be done, a craniotomy can be done to relieve pressure on the brain. There is a special procedure called an endovascular coiling that clots the blood within the aneurysm using a minimally invasive technique.
Patients with subarachnoid haemorrhage need to be supported form a life support standpoint. They may need intubation and control of blood pressure in order to decrease the bleeding. Mannitol and steroids are used to decrease the pressure on the brain. A tube may need to be inserted into the skull in order to drain excess blood from the brain. Anti-anxiety medications and pain killers are used to control the common agitation and pain associated with the condition. Medications against seizures are also often given as the seizure rate is high. If you think that your condition has worsened as a result of medical negligence, contact our brain haemorrhage solicitors for advice at no cost.
Subdural Haemorrhage Overview
A subdural haematoma involves a collection of bleeding lying on the surface of the brain. It usually the result of having a severe head injury, such as with a fall, a motor vehicle accident or a sports injury. If the subdural haematoma is acute, it can be very dangerous-even deadly. The bleeding rapidly fills the spaces in the skull and around the brain, increasing the pressure in the brain and causing death from herniation of the brain. The brain is frequently injured with occasional permanent results.
In the elderly, subdural haematoma can occur after a minor fall or other injury. They can be subacute or chronic and can lead to changes in gait and personality. The elderly person may develop dementia-like symptoms that are written off to old age. Only through thorough testing can the diagnosis of chronic subdural haemorrhage be made. If you think that your condition has worsened as a result of medical negligence, contact our brain haemorrhage solicitors for advice at no cost.
The cause of a subdural haematoma is the bleeding of the small blood vessels that connect the brain to the overlying covering or dura. The vessels stretch and tear after an injury so that blood collects within the space. In the elderly, the veins are already stretched because the individual has an atrophied brain that is shrunken into the space between the brain and the dura mater.
Sometimes a subdural haematoma happens in the absence of an injury. This can occur when the person is on anticoagulant therapy due to other reasons, is a long term drinker, suffers from recurrent falls (such as in an alcoholic), has repeated head injury (such as a football player) or someone who is very young or very old.
The symptoms of a subdural haematoma include confusion, speech abnormalities, balance or walking difficulties, severe headache, loss of consciousness, lethargy, vomiting and nausea, seizures, numbness of a part of the body, weakness, visual changes, or slurring of speech.
If a subdural haematoma occurs in an infant, the symptoms can be different and can include the presence of a bulging fontanelle, which is one of the soft spots of the skull. There can be focal seizures and difficulty feeding. The cry can be high pitched and there can be a sudden increase in head circumference. Generalized seizures are also possible and the baby may seem to be lethargic. There is persistent vomiting, irritability and separation of the sutures of the skull.
Doctors need a relatively quick diagnosis of a subdural haematoma, especially if the situation represents an acute subarachnoid bleed. There should be a complete physical and neurological exam. Sometimes bruising can be seen in the area of trauma. The doctor might find confusion in the speech or an inability to speak; there can be problems with walking or balance; a headache can be asked about; there can be loss of consciousness or lethargy. The doctor may find localized numbness of a body area as well as nausea and vomiting. In an elderly person, there can be a sudden or relatively sudden loss of cognition.
Other tests that can be done include a CT scan or MRI scan of the brain, which can show up areas of bleeding in a subdural haematoma. It can also show the degree of pressure on the brain.
The treatment of subdural haemorrhage includes emergency craniotomy to take extra bleeding and pressure off the brain. It may be enough to drill a small hole on the side of the subdural haematoma so that the blood can flow outward. Mannitol is used to control swelling on the brain and medications for seizures and pain need to be given. If the person is unconscious, there may be a need for ventilator support. Blood pressure needs to be decreased so that the flow of blood through the brain is under less pressure. Corticosteroids are used to decrease the pressure and inflammation on the brain.
Both subdural haemorrhage which is often slowly evolving, frequently starting after trauma to the head and extradural haemorrhage which usually occurs after a head injury are often not diagnosed resulting in serious subsequent injury or death.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here