Failure to diagnose and treat a subarachnoid haemorrhage (stroke) in time can lead to coma, death or permanent disability in two-thirds of cases.
At least a third of all subarachnoid haemorrhages end in death – usually within 24 hours. Claiming compensation can never replace a lost loved one but it will give your family the vital financial security it needs.
Your legal action would also make the hospital change its procedures to stop the same thing from happening to other families.
Patients who survive a subarachnoid haemorrhage can be left with life-changing brain injuries. Some require care for the rest of their lives and adaptations to the family home to them help cope with their disability.
Did the doctors treating you or your loved one fail to spot the warning signs of a subarachnoid haemorrhage in time? Did they fail to act swiftly and carry out the correct scans and tests?
What Is A Subarachnoid Haemorrhage (SAH)?
A subarachnoid haemorrhage (SAH) is a rare but severe type of stroke caused by bleeding between the membranes on the surface of the brain. It is usually caused by a ruptured brain aneurysm – a rip or tear in a brain artery.
Usually these ruptures occur without warning – giving families and doctors very little time to act. Immediate treatment is critical in what little time the patient may have.
The patient may experience a number of symptoms while the brain aneurysm is still a bulge in the artery but many are symptomless. So doctors may not be able to spot the aneurysm before it ruptures.
What Causes A Subarachnoid Haemorrhage (SAH)?
An SAH has two major impacts on the brain:
- Blood leaks into the subarachnoid space damages brain cells.
- Parts of the brain are then deprived of oxygen-rich blood because it is leaking out of the damaged artery. This causes a stroke.
A brain aneurysm that leads to an SAH can be caused by:
- an inherited medical condition
- abnormal blood flow at an arterial junction
- atherosclerosis (deposits of fatty substances on the walls of the artery)
- a trauma injury such as a blow to the head.
A ruptured brain aneurysm is the most common cause of SAH but it is not the only one. Other causes include:
- Arteriovenous malformation (AVM) – in which the arteries and veins are badly formed and tangled. AVMs can occur anywhere in the body but are particularly dangerous in the brain. An AVM can put a great deal of pressure on the walls of the arteries. This weakens them until they become vulnerable to a possible breach, causing life-threatening internal bleeding.
- Brain tumour – early symptoms can include headaches, vision problems and mood changes. Your GP should refer you promptly to hospital for a scan. Failure to do so can have life-threatening consequences. Was your GP slow to refer you? Were there any delays before you or your loved one received a scan in hospital?
- Brain infection (encephalitis) – caused by viruses as herpes simplex (which causes cold sores), varicella zoster (which causes chickenpox and shingles), measles, mumps, rubella or viruses spread by animals. In rare cases it can be caused by bacteria, fungi or parasites.
- Vasculitis – inflammation of the blood vessels in the brain. This can be caused by Hepatis B or C infections, cancer of the blood, rheumatoid arthritis, lupus (a long-term auto-immune disease) and scleroderma (the immune system attacking connective tissue under the skin and around vital organs).
When you claim compensation, the NHS trust or private hospital that treated you may try to suggest that your genetics were part of the cause – in a bid either to deny blame or to reduce the damages it would have to pay you.
In the case of atherosclerosis, they may also try to claim that your lifestyle was partly to blame for your subarachnoid haemorrhage. They may suggest that the fatty deposits in your arteries were caused by smoking, excessive alcohol consumption or high cholesterol.
But – in every case – our experienced clinical negligence solicitors can call on medical experts to provide detailed analysis and specialist clinical reports and testimony to help you prove your case. It pays to have the experts on your side.
In the event that your SAH was a traumatic subarachnoid haemorrhage (one caused by an injury), we can also call on the additional expertise of our specialist personal injury solicitors.
Coles Miller’s Personal Injury Department is led by Managing Partner Adrian Cormack, an Accredited Brain Injury Specialist solicitor (one of just a few in the South West and the only one in Dorset).
What Are The Symptoms Of A Subarachnoid Haemorrhage?
An SAH can be incredibly sudden – giving little or no warning. It can happen during physical exercise or exertion. This need not be an extreme or exhausting activity. It could be something as innocuous as lifting something heavy or bulky, or perhaps even just a coughing fit.
What few warning signs there are can include:
- a sudden and very severe headache – described by some survivors as “the worst headache I’ve ever had”
- stiff neck
- photophobia (sensitivity to light)
- blurred vision, seeing double
- slurred speech, weakness on one side of your body
- collapse, unconsciousness or convulsions.
Doctors must act swiftly when confronted with these symptoms. But some – such as nausea or a stiff neck – could be mistaken for other conditions. This could lead to delays, with serious or even fatal consequences. Did your GP or hospital doctors fail to act in time? Did they delay their diagnosis...or initially misdiagnose the condition as something else?
How Should Hospital Doctors Diagnose And Treat An SAH?
A subarachnoid haemorrhage is a serious medical emergency that requires the highest standards of medical treatment.
The patient should be taken to hospital immediately and undergo a Computed Tomography (CT) scan as quickly as possible. CT angiography involves injecting a contract into the bloodstream to view the arteries of the brain.
Doctors may carry out a magnetic resonance imaging (MRI) scan that uses a magnetic field and radio-frequency waves to create a detailed view of the soft tissues in the brain.
What if the scans do not show an SAH? The doctors have the option to carry out a lumbar puncture procedure to check the patient’s cerebrospinal fluid (CSF) for signs of bleeding to the brain.
A lumbar puncture involves injecting a hollow needle into the lower back to detect blood in the cerebrospinal fluid. It is a ‘safe’ procedure but there are some possible risks or side-effects including headaches, backache, nausea, vomiting, dizziness, short-term numbness in the legs, infection and bleeding in the spinal canal.
Treating an SAH means stopping the bleeding in the brain. This requires neurosurgery so the patient may be transferred from their local hospital to a major regional city hospital with the appropriate specialist facilities.
The neurosurgeon will repair the damaged blood vessel under general anaesthetic by either:
- ‘clipping’ it to stop further blood loss
- ‘coiling’ – feeding platinum coils into the artery via a catheter in the patient’s leg; doctors prefer this procedure because it has a lower risk of short-term complications such as seizures.
Complications And Long-Term Effects Of A Subarachnoid Haemorrhage
Even those patients who recover from a subarachnoid haemorrhage can be at risk from further significant health issues.
One of the biggest concerns is rebleeding – the sealed brain aneurysm could burst again with all the associated high risks of death or disability. The risk is highest in the first few days after the SAH. Aneurysm repairs must be carried out as soon as possible to reduce the risk of rebleeding.
Other possible complications include:
- Delayed cerebral ischemia (vapospasm) – blood supply to the brain becomes dangerously low, causing brain damage. The patient is most at risk in the first few days after the initial haemorrhage. Symptoms include drowsiness, coma and stroke-like weakness on one side of the body. Recognised treatments include the drug nimipodine (which has side effects – nausea, increased heart rate, headaches, rash).
- Hydrocephalus – fluid on the brain, causing brain damage. This is common because a haemorrhage can disrupt the production and drainage of cerebrospinal fluid, leading to increased fluid around the brain. It can be treated with a lumbar puncture or a temporary tube surgically implanted into the brain to drain the excess fluid.
Long-term effects of an SAH can include:
- epilepsy (repeated seizures/fits) – these affect five per cent of subarachnoid haemorrhage survivors
- problems with memory, concentration and difficulty planning even simple tasks
- mood swings, depression and anxiety
- Post-traumatic Stress Disorder (PTSD) – in which the person relives the haemorrhage through a series of flashbacks and nightmares
- feelings of isolation, irritability and guilt.
Compensation claims for medical negligence can include damages for psychological injuries such as those outlined above.
Recovering From A Subarachnoid Haemorrhage
Even those fortunate enough to recover from a subarachnoid haemorrhage are likely to experience weakness or paralysis in the arms and legs, speech difficulties, seizures, fatigue and headaches.
The path to recovery is slow (weeks, months and years) but not steady. Many victims of brain injuries – not just an SAH – experience ups and downs, good and bad days.
You may need expert help from rehabilitation specialists, physiotherapists, speech and language experts and occupational therapists.
Typical problems experienced by those recovering can include extreme tiredness, difficulty sleeping, headaches, loss of feeling or movement. Your senses of smell and taste may grow stronger or weaker.
You may suffer from vision problems. Blurring, blind spots, black spots and double vision are common. With help and treatment from an eye specialist, you may find that these problems become less severe over subsequent months.
These long-term effects are likely to affect your work and your ability to earn a living and support your loved ones. You will also need money to help fund your treatment and care if you need to go private.
Claim Compensation – No Win, No Fee – Book A Free Chat
You can use a ‘no win no fee’ agreement to take legal action against the GP surgery or hospital that failed to diagnose and treat your subarachnoid haemorrhage correctly.
No win no fee means there is no financial risk to you. In the unlikely event that you lose your claim, all the legal fees are covered by insurance.
Contact Coles Miller solicitors David Simpson or Lydia Barnett today for a free, informal and confidential chat about your potential compensation claim.
David Simpson is the Partner who leads the Medical Negligence team at Coles Miller. Lydia Barnett, also a Partner, has a special interest in cases involving brain injuries and delayed diagnosis of strokes.