Subarachnoid Haemorrhage Complaint - Queensland QLD Solicitors

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If you think that you have received inadequate or negligent medical treatment for subarachnoid haemorrhage, our solicitors will be able to assist you in making a complaint to the Office of the Health Ombudsman (OHO) in Queensland. Our QLD based solicitors deal with health care complaints on a ‘pro bono’ basis and will not make any charge to you for advice on how to make a complaint to the Office of the Health Ombudsman. A complaint to the Office of the Health Ombudsman in QLD is not a medical negligence compensation claim and will not result in the payment of compensation but may assist you in further understanding what went wrong and why you were treated in the way that has caused you concern. There are a number of possible outcomes and the Queensland Office of the Health Ombudsman may be able to obtain a more full explanation of the circumstances of any alleged negligence or may give you more details about the treatment that you have received.

Subarachnoid Hemorrhage

A subarachnoid haemorrhage (SAH) involves bleeding into the subarachnoid space, which is the space between the subarachnoid membrane and the pia mater, which is up against the brain. It can come from a ruptured cerebral aneurysm or from a traumatic head injury.

The incidence of subarachnoid haemorrhage increases with age and affects 9 out of 100,000 people throughout the world. There are higher rates in Finland and Japan but doctors do not know why this is the case. Women have a slightly higher risk of getting a subarachnoid haemorrhage than men.

It is believed that genetics plays a role in who gets this disorder. Lifestyle factors include smoking, high blood pressure and use of alcohol. Young people engaging in aggressive driving are at risk of getting a SAH in a motor vehicle accident. Being Caucasian increases the risk of SAH as does being on hormone replacement therapy and having diabetes mellitus. A total of 4 percent of bleeds occur following sexual intercourse and 10 percent report having bent over to lift something heavy.

Symptoms of having a SAH include having a sudden severe headache, confusion, a lesser degree of consciousness, vomiting, and seizures. Patients with these symptoms can have their SAH confirmed by having a CT scan of the head or a lumbar puncture. The patient needs immediate surgery to drain the bleeding so that there is less pressure on the brain. Too much pressure on the brain and the brain will herniate through the base of the brain, resulting in sudden death.

If the SAH was caused by an aneurysm, it was historically treated with open surgery. Since the 1990s, however, a procedure called “coiling” was developed that is now used to get rid of the bleeding from the aneurysm. It can be done on aneurysms that are not bleeding.

Subarachnoid haemorrhage is a type of stroke. It represents up to 7 percent of all strokes and is considered a medical emergency, leading to sudden death or severe disability, even when managed properly. About half of all SAH patients die and up to 15 percent die even before making it to the hospital. Neurological impairments following the SAH are common.

The headache described in SAH is often called a “thunderclap headache” because it feels like being kicked in the head. It develops over seconds and pulsates toward the back of the head. One out of fourteen patients will seize and many will vomit. The patient can rapidly progress to having a coma. When the pupillary light reflex begins to disappear, it is a sign of brain herniation and sudden death.

There can be a syndrome where the affected eye looks downward and the eyelid on the same eye cannot be lifted. This is a sign of SAH. If the haemorrhage comes from an aneurysm as opposed to trauma, there is a greater chance of seizures. If a patient has had a head injury from an accident, he or she will have a headache, a reduced level of consciousness and weakness on one side of the body.

The main cause of a subarachnoid haemorrhage is some type of trauma. The rest are due to a ruptured cerebral aneurysm. Most aneurysms are located in the circle of Willis and its branches. The larger the aneurysm, the greater is the chance that it ruptures. Some haemorrhages can be due to some other reason besides trauma or an aneurysm. Cocaine abuse can cause SAH as can clotting problems and sickle cell anemia.

Trauma causing an SAH includes motor vehicle accidents, falls from great heights, motor cycle accidents, and accidents resulting in skull fractures. The SAH is located on the side of the head that has the skull fracture.

A thunderclap headache can occur in other diseases besides an SAH. It can occur in migraine headaches, meningitis, cerebral venous sinus thrombosis, or in an intracerebral hemorrhage. Because of this, sometimes the confirmatory CT scan of the head is delayed to the detriment of the patient. In some cases an MRI of the brain can be done. It is more sensitive than a CT scan of the head when it is done several days out of the onset of symptoms.

If a lumbar puncture is done at the onset of symptoms, blood would have filtered down around the spinal cord, leading to blood in the cerebrospinal fluid during a lumbar puncture. It is found 3 percent of the time when the CT scan was found to be normal. This means that even if imaging is negative, if an SAH is suspected, a lumbar puncture is mandatory. Three tubes are collected and if the same number or RBCs are found in all three vials, a subarachnoid hemorrhage is strongly suspected. Xanthochromia or “yellow color” to the CSF is another reliable way to detect the SAH, especially if several days have gone by since the symptoms first started.

Patients also receive an angiogram of the head to see where the bleeding originates. If it comes from an aneurysm, it can be located and coiled to stop the bleeding. CT scan angiography can be done in place of regular x-rays. It shows the location of the aneurysm in the best possible way.

There are several ways to grade an SAH. The Glasgow Coma Scale is a scale used for anyone with a reduced level of consciousness. There are three specialised scores just for SAH. The higher the number, the worse is the outcome of the patient. These are the scales that can predict the outcome of any given case of SAH.

People with autosomal dominant polycystic kidney disease have a hereditary condition in which the rate of cerebral aneurysms is 8 percent. Most are small and will never rupture. Screening is recommended in families who have the disease and have had a family member that has had a cerebral bleed before.

HELPLINE: 07 3613 7325