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Subarachnoid Haemorrhage - Medical Negligence Lawyers

A subarachnoid haemorrhage involves bleeding between the brain and the thin membrane that covers the brain. This space is known as the subarachnoid space. It is a very serious type of brain bleed that is caused by trauma to the head or a broken blood vessel in a person with a bleeding disorder.

Subarachnoid haemorrhages due to aneurisms happen in about 10-15 individuals out of 10,000. The most common individual to get such a haemorrhage is aged between 20 and 60. Women tend to get a subarachnoid haemorrhage from an aneurism more commonly than men.

Brain haemorrhage compensation claim 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.

If you have been injured by a healthcare professional including a doctor, dentist, nurse or technician and would like to speak to a medical negligence lawyer without further obligation, just use the helpline. A Subarachnoid Haemorrhage medical negligence lawyer who deals exclusively in personal injury claims will speak to you, giving free advice and information on how best to preserve your legal right to receive compensation as a result of injuries caused by medical negligence. Our brain haemorrhage compensation claim solicitors deal with legal action for medical negligence using the no win no fee scheme.

Our Subarachnoid Haemorrhage medical negligence lawyers have solicitors offices situated in Adelaide, Canberra, Melbourne, Perth, Sydney, Brisbane and Darwin.

Causes

A subarachnoid haemorrhage can be caused by having a head injury, having an arteriovenous malformation or cerebral aneurism, a bleeding disorder or from an unknown underlying cause. People who use blood thinners are more likely to get a subarachnoid haemorrhage than those who are not. Among head injuries, motor vehicle accidents are the most common cause of a subarachnoid haemorrhage.

Risk factors include having an aneurism, having a condition known as fibromuscular dysplasia or other connective tissue disease, smoking, having polycystic kidney disease or high blood pressure. In some cases, there can be a family history of aneurisms that contribute to subarachnoid haemorrhages.

Symptoms

A sudden, severe headache is one of the most common symptoms of a subarachnoid haemorrhage. It unlike any type of headache pain and you may feel a popping sensation or snapping sensation due to rupture of the artery. There is often a sudden loss of consciousness or extreme lethargy. There can be irritability or changes in mood and personality. There can be nausea, vomiting and problems with light bothering the eyes (photophobia). Seizures are common as is a stiff neck. Double vision can be another finding.

Doctors often note a difference in papillary size, drooping of the eyelids, seizures and stiffness of the back or arching of the back. These are all signs of increased intracranial pressure of sudden onset.

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.

Evaluation

A physical examination often shows a stiff neck because there is blood in the subarachnoid space. There may be a focal neurological deficit or decreased nervous system activity (coma). One pupil is often much bigger than the other. As for medical tests, a CT exam of the head is important to do. Blood shows up as bright on the X-ray film so that the abnormal blood will be visible. One can also see compression of the brain tissue as a result of the bleed. Small bleeds may not show up initially, leaving the doctor to do a spinal tap to look for blood in the subarachnoid space. In some cases a CT scan with angiography and the use of contrast dye will show up a small subarachnoid bleed. Cerebral angiography is a slightly better test because it shows the exact area of bleeding. A newer technique involves using transcranial Doppler ultrasound to detect blood flow and areas of blood vessel spasm. An MRI or magnetic resonance angiography can be done to find the subarachnoid haemorrhage and to see how much pressure is on the brain.

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.

Treatment

Surgery is often recommended to save the life of the individual with a subarachnoid haemorrhage. If the haemorrhage is related to a traumatic injury, surgery is performed to remove large collections of blood and to relieve excess pressure on the brain. If the bleed is related to an aneurism, the aneurism must be repaired or removed. Doctors perform a craniotomy and clip the aneurism so it has no blood supply to do any further damage.

There also needs to be significant supportive treatment including intubation, treatment to lower the blood pressure, treatment to decrease seizures and mannitol, which decreases the amount of pressure within the brain. Painkillers and anti-anxiety medication are used to keep the patient comfortable and calm.

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.

Prognosis

The patient can fully recover if they have prompt treatment and if the bleed is small and doesn’t push too much on the brain. In cases of larger subarachnoid haemorrhages, the patient can suffer from permanent neurological deficit or death.

Subarachnoid Haemorrhage Overview

A subarachnoid haemorrhage is bleeding around the brain between the dura of the brain and the skull. It occurs at a time when a blood vessel in or outside the dura ruptures and does not stop bleeding. The subarachnoid space fills with blood quite quickly.

Patients suffering an acute subarachnoid haemorrhage will experience the sudden onset of a severe headache (the worst headache they have had) and will have neck pain, nausea and vomiting. Because it is such a fast output of blood, there is a sudden onset of a loss of consciousness and death.

A subarachnoid haemorrhage is usually caused by a rupture of a cerebral aneurysm near the base of the skull. A cerebral aneurysm is an irregular or bulging aspect of an artery. The bulging artery has a thin wall and can easily rupture.

The actual cause of cerebral aneurysms is not clear. They can be congenital or can develop in childhood. They grow slowly and can be multiple in nature. People who are of any age can get a subarachnoid haemorrhage, including teenagers and the elderly. Slightly more women get the condition when compared to men. People can get a subarachnoid haemorrhage from trauma as well. A hit to the head can break blood vessels just beneath the skull, leading to a haemorrhage that progresses rapidly.

The diagnosis of a subarachnoid is best made with a CT scan or lumbar puncture. The lumbar puncture is helpful because it will she bleeding down to the level of the lumbar spine. A cerebral aneurysm will be necessary to find the exact source of the pain, using x-ray and contrast dye. If the subarachnoid haemorrhage is stable enough, surgery can be done to tie off the aneurysm and clean out the bleeding in the subarachnoid space.

Because the subarachnoid haemorrhage is life-threatening, patients need to be stabilized and sent to a specialty trauma center where a burr hole in the skull often relieves some of the intense pressure on the brain. Cardiac arrhythmias and pulmonary edema are common complications of this condition. Neurosurgeons need to worry about bleeding happening again or the onset of hydrocephalus.

There is a high morbidity and mortality with subarachnoid haemorrhages in the range of 10 percent who die before even reaching the hospital and 40 percent who will die while in the hospital before a month is up. If there is a ruptured aneurysm, it needs to be clipped or coiled to make sure it doesn’t bleed again. Those that die will often die from cerebral vasospasm or from hydrocephalus. There are often coexisting medical problems that increase morbidity and mortality.

There are rare causes of a subarachnoid haemorrhage which include:

  • Arterial dissection
  • Cerebral arteriovenous malformations (AVMs)
  • Septic aneurysms
  • Dural arteriovenous fistula
  • Anticoagulants
  • Bleeding disorders
  • Pituitary apoplexy
  • Amyloid angiopathy
  • Using cocaine or methamphetamines

There are several predisposing factors or contributory factors to getting a subarachnoid haemorrhage. These include:

  • Having high blood pressure that is not properly treated with antihypertensives
  • Having a smoking history or actively smoking at the time of the bleed
  • Drinking heavily, especially if you are a binge drinker
  • Having a first degree relative who has had a subarachnoid haemorrhage, which gives a four percent chance of having your own haemorrhage
  • Having a known, heritable connective tissue disease like Marfan’s syndrome or Ehlers-Danlos syndrome

The incidence of subarachnoid haemorrhage is about 3,000 cases per year Australia or about 0.06 to 0.16 per 1000 people per year in Australia. Risk increases with age. The mean age at onset of the haemorrhage is about 50 years with a prevalence of women over men. If you have a first degree relative who has had a subarachnoid haemorrhage from an aneurysm, you have four times the incidence of having your own subarachnoid haemorrhage.

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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