Brain haemorrhage and medical negligence
There are many causes of brain haemorrhage these include:
- high blood pressure – particularly blood pressure which has remained uncontrolled for a long period of time
- abnormal blood vessels in the brain (e.g. an arterial venous malformation)
- blood thinners (anticoagulation)
- a tumour that may bleed
- drug use (e.g. cocaine) – this can cause severe high blood pressure (hypertension) which then, in turn, can lead to haemorrhage
- bleeding disorders such as haemophilia and sickle cell disease
- a burst aneurysm (a weakness in a blood vessel wall)
- trauma/head injury
The brain is encased in a rigid box (the skull). It is protected by a membranous layer known as a meninges which covers the brain, which is in turn protected by further layers of membrane known as the dura.
Some bleeds develop slowly and some can be large catastrophic bleeds. Not all of them require surgery.
Diagnosis – How should a brain bleed be identified?
There are various tests that can be undertaken to diagnose whether a person has a bleed. The tests will also identify where exactly the bleed is to allow the doctors to make a decision on the most appropriate treatment. Investigations into a suspected brain bleed include the following:
- a good physical examination
- a CT/MRI scan
- an angiogram (this is an x-ray using a contrast dye which is injected into the blood vessels and is then seen on screen. It will show up abnormalities in blood vessels such as an aneurysm or an AVM)
- blood tests – these can identify clotting problems or whether a person has sepsis, inflammation and immune disorders
How bleeds on the brain should be treated
Bleeds on the brain are treated based upon the type of bleed encountered:
- abnormalities of blood vessels such as an aneurysm can be treated without open surgery. Some treatments can be done in the catheter lab. In some cases a blood vessel abnormality or aneurysm can be coiled or stented
- pressure from the haemorrhage can be relieved by drilling a hole into the skull and relieving the pressure
- medical treatment such as reducing blood pressure
- not all brain bleeds are operable
The earlier the treatment for any brain bleed the better the outcome and the more brain function you retain in the long term.
Signs and symptoms of a brain bleed
- vision problems e.g. blurred vision or double vision
- symptoms similar to those of a stroke caused by a clot, i.e. a facial droop, weakness down one side of the body, inability to speak properly or speaking in a slurred fashion
- long-term effects can include effects on memory, reasoning and confusion
Types of brain bleeding
The type of bleeding reflects the area of the brain where the bleed is found. This can be in the epidural space, the subdural space, the subarachnoid space or inside the brain itself (intracerebral).
Do you have a case for negligence as a result of a bleed on the brain?
The common cases we see include:
- a delay in diagnosing and treating a brain haemorrhage
- delay in obtaining a CT or MRI scan
- poor blood pressure control by the GP over a long period of time
- poor management of anticoagulation (e.g. monitoring of your INR level when taking warfarin for another problem)
Every brain bleed case we see is different. Please call us to discuss yours in more detail.