Home | Business News | Browse by Publication | T | Trial

It's more than a headache: quick, accurate diagnosis and treatment of patients with ruptured brain aneurysms and subarachnoid hemorrhage can save lives. Here's how to determine whether your client received the appropriate - and most responsive - care.

Article Excerpt
Every year, more than 30,000 people in the United States suffer a ruptured brain aneurysm resulting in a life-threatening subarachnoid hemorrhage--bleeding around the brain. (1) Thousands of these people will go promptly to their local emergency room or family physician and report that they are experiencing the worst headache of their lives. Unfortunately, many will be discharged without receiving the correct diagnosis or the emergency medical treatment they desperately need.

Failure to diagnose is the most common negligence in the treatment of patients with aneurysmal subarachnoid hemorrhage, (2) and this failure may be as high as 53 percent in patients visiting the emergency room for the first time. (3) Physicians fail to obtain an adequate history, perform a thorough neurological exam, or understand the significance of the history and physical exam findings. (4) Less often, but still with troubling regularity, negligence involves failure to obtain or accurately interpret diagnostic tests.

Delay in diagnosis and treatment has dire consequences. In some cases, even minimal delay can mean the difference between life and death.

To adequately evaluate a potential malpractice case involving the failure to timely diagnose and treat a patient with a ruptured brain aneurysm, you must first gain a basic understanding of brain aneurysms, how they rupture, and the events that follow.

Aneurysms are ballooned areas on arteries. They are often referred to as berry, saccular, or congenital (existing at birth) aneurysms. The most likely cause is a weak area of the artery wall due to a congenital defect combined with degenerative changes that further weaken the tissue. (5)

Aneurysms are typically located on large arteries at the base of the brain and usually occur at branching points. If they stretch and ultimately rupture, arterial pressure forces blood to leak from the aneurysm into the subarachnoid space--the area between the arachnoid membrane and the pia mater, a membrane adherent to the brain. The blood then quickly spreads into the cerebrospinal fluid surrounding the brain and spinal cord.

This results in a sudden increase in intracranial pressure and chemical irritation of the meninges, which leads to a sudden, explosive headache. (6) Headaches caused by ruptured aneurysms may be associated with physical exertion in up to 20 percent of patients. (7)

Significantly more women than men, and more blacks than whites, suffer ruptured brain aneurysms. The risk of rupture increases with age and in people with a family history of intracranial aneurysms. It also increases dramatically during the third trimester of pregnancy and contributes to between 6 percent and 25 percent of maternal deaths. (8) Lifestyle risk factors include smoking, uncontrolled hypertension, heavy alcohol use, and cocaine or amphetamine abuse. (9)

Cerebral aneurysms are more common in people with fibromuscular dysplasia (which causes narrowing of the arteries) and several hereditary diseases. (10) Aneurysms may occur as multiples. Following the treatment of...

View this article FREE - Now for a Limited Time, try Goliath Business News
Free for 3 Days!