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Subdural Haemorrhage - Medical Negligence Lawyers

A subdural haemorrhage involves bleeding beneath the dura or lining of the brain. It is also called a subdural haematoma, when the blood collects into a clot beneath the dura. It is almost always related to a traumatic event, such as a skull fracture or blunt trauma to the head.

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.

Causes

A subdural haematoma is the result of a significant head injury. It is divided into two types: an “acute subdural haematoma” and a “chronic subdural haematoma”. Acute subdural haematomas fill the space between the brain and the dura really fast, compressing brain tissue quickly so that brain damage is possible. A minor head trauma can result in slow bleeding into the subdural space. This causes a chronic subdural haematoma. The individual is often elderly and exhibits symptoms of gait disturbances and dementia of a relatively rapid onset. Only a CT scan can tell if the problem is actually due to a chronic subdural haematoma. In rare cases, subdural haematomas can happen in the absence of any known trauma.

Risk Factors

Common risk factors include alcohol abuse, anticoagulant medication such as aspirin and warfarin, repeated head injury, being very old or very young or having a risk for falls.

Symptoms

Those adults who have an acute subdural haematoma often have difficulty with walking or balance, speech which is confused, moderate to severe headache, nausea, vomiting, loss of consciousness, lethargy or confusion, seizures, numbness, visual changes, slurred speech and weakness.

Infants can display bulging fontanelles, seizures, feeding problems, a high pitched cry, lethargy or sleepiness, irritability, ongoing vomiting, increased head circumference and separation of the sutures where the skull is growing together.

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.

Diagnosis

If you think you or a loved one has had a head injury, seek medical advice immediately. If that person is an adult, consider the possibility that their confusion is due to a chronic subdural haematoma. Doctors will perform a complete neurological examination and consider ordering brain imaging. The best imaging test for bleeding in the brain area is the CT scan of the head. Blood shows brightly white on a CT scan of the head and is easily seen by the radiologist. An MRI scan of the head will also show bleeding within the skull.

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

A subdural haematoma is considered a medical emergency. Doctors generally do emergency surgery to drain the subdural haematoma and to relieve the pressure within the brain. It can be as simple as drilling a small hole over the haematoma and allowing the blood to evacuate. If there is a firm clot, doctors may need to do a craniotomy, which removes a segment of the skull in order to manually remove a large or stubborn blood clot.

Doctors also use medications to lower the blood pressure, such as diuretic therapy and often use corticosteroids in order to reduce swelling of the brain. Anti-seizure medications are used to prevent seizures and mannitol is used to reduce the overall pressure in the brain.

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

There are many outcomes in subdural haematoma and it all depends on its location, its size and how quickly you seek medical attention. It also depends on whether or not there have been other brain injuries, such as an injury to the brain itself. Acute subdural haematomas have a relatively high death rate, with subacute and chronic subdural haematomas being less deadly. In cases of chronic subdural haematomas, the patient often needs some medical care and rehabilitation but can return to normal functioning after the rehabilitation is over with. Many people continue to suffer from seizures even after the acute phase is over with but these can be controlled with anti-seizure medication.

Complications include haerniation of the brainstem, often resulting in coma and death, ongoing neurological symptoms, seizure disorders and difficulty in areas of numbness, weakness and speaking.

Medical Negligence Solicitors

According to the World Health Organisation the highest incidence of medical negligence in the developed world occurs in Australia. If you have been injured by a healthcare professional including a doctor, dentist, nurse or technician and would like to speak to a subdural haemorrhage medical negligence lawyer without further obligation, just use the helpline. A 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 subdural haemorrhage medical negligence lawyers have solicitors offices situated in Adelaide, Canberra, Melbourne, Perth, Sydney, Brisbane and Darwin.

Subdural Haemorrhage Overview

A subdural haemorrhage is a bleed that occurs outside the brain but inside the confines of the dura mater. The most common cause of a subdural haemorrhage is a significant head injury. Complications include increased pressure of the intracranial space, which leads to coma and death. Subdural haemorrhages are life-threatening unless they resolve spontaneously. They require surgery to correct in most cases.

The bleeding in a subdural haemorrhage is between the arachnoid layer and the dura layer. The bleeding is not within the brain itself. Because it is close to the brain, however, the brain cavity swells, which causes the neurological findings seen in this condition. The swelling leads to herniation of the brain into the foramen magnum, interfering with the brainstemís ability to control the heart and respirations. In essence, it is not compatible with life.

The most common cause of a subdural haemorrhage is a serious head injury. This can be caused by an assault, a motor vehicle accident, sports injury or a fall from a great height. Subdural haemorrhages can be acute, because of having a sudden onset, subacute, having a medium length of onset and chronic, having a slow onset of symptoms.

A risk factor for having a subdural haemorrhage includes being on blood thinners. Another risk factor is having a bleeding disorder. Minor head trauma can cause a subdural bleed in these people. In chronic subdural haemorrhages, the symptoms may not appear in the patient for several days to several weeks. This type of hematoma is more prevalent in the elderly who have brain shrinkage and stretching of tiny veins beneath the dura. A spinal tap is an unusual cause of a subdural hematoma.

There are several symptoms of a subdural haemorrhage. The symptoms seen are largely due to the rate of bleeding of the haemorrhage. The symptoms include:

  • Immediate loss of consciousness and coma in patients with severe head trauma
  • In chronic disease, the symptoms are slow in onset and show up as confusion, which progresses to coma in a few days
  • In slow growing haemorrhages, the onset of symptoms occurs as late as two weeks or more post-incident
  • Headache of a varying nature
  • Confusion
  • Dizziness
  • Behavioral changes
  • Nausea
  • Vomiting
  • Feeling drowsy or tired
  • Weakness, which can be diffuse or in certain extremities
  • Seizures
  • Being apathetic

The symptom of subdural haemorrhage can vary widely, depending on the size of the blood clot, the location of the blood clot and the rapidity with which the blood clot grows.

The subdural haemorrhage needs to be diagnosed soon after the patient arrives in the emergency room. The best test is a CT scan of the head because blood shows up easily in such a scan. In a MRI exam, the subdural haemorrhage is more easily seen but it is a more expensive test and is less likely to be available at smaller hospitals. Less commonly, an angiogram is necessary. This uses dye and x-rays to find the source of the bleeding.

The treatment of subdural haemorrhages is dependent on their severity. Small lesions can simply be watched, while serious, life-threatening bleeds need surgery.

Some treatments include:

  • Burr hole treatments: This is an emergency procedure that makes a nickel-sized hole in the skull so that blood can be sucked out successfully.
  • Craniotomy: This is when a large section of bone is removed so that the blood clot can be evacuated.
  • Craniectomy: In such cases, the patient has a section of bone removed for a long period of time to let the swelling ebb and flow so that it can finally abate.

Some patients need to be on a ventilator to manage their vital signs while ill or in a coma. If there are bleeding issues, they need to be corrected so that the bleeding stops. Medication to control swelling on the brain and to decrease inflammation may be necessary.

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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