What is a Subarachnoid Haemorrhage?
Sub-arachnoid haemorrhage is a type of brain injury that involves a sudden leakage of blood from a ruptured blood vessel in the brain. The cause is usually a weakness in the vessel wall (aneurysm) combined with the pressure of the circulating blood. The higher the blood pressure the greater the risk of a burst in a weakened vessel. Smokers and people with high blood pressure are most at risk.
A sub-arachnoid haemorrhage is most common in older people but it can also occur in young people with an inherited aneurysm. Classically the bleed occurs during physical effort, such as coughing or straining on the toilet, when the pressure of blood in the brain is temporarily raised.
The initial symptom is usually a sudden, intense headache that lasts for more than an hour, often at the back of the head. Vomiting and collapse and sometimes loss of consciousness often follow.
In about half the cases there is a small leak before the serious rupture occurs resulting in a very bad headache, but this warning sign is often missed, probably because headaches and dizzy spells are so common.
If a sub-arachnoid haemorrhage does occur resulting in serious injury or death, and if the warning signs that could have lead to successful surgery were not picked up, a claim for negligence may be possible.
Neurosurgical operations to repair, or clip, the aneurysm can also sometimes be performed negligently.
Obtaining damages in situations such as this are rarely straightforward so it essential to consult an experienced Clinical Negligence Solicitor if you think you might have a case.
If you are unhappy with the treatment you have received, results of the operation or believe the surgeon or hospital has been clinically or medically negligent please contact our specialist clinical negligence team for confidential advice via our online enquiry form or please contact us on 0845 402 0001.
Clinical Negligence Case Study I
A woman of 51 went to her GP complaining of an intense headache, the like of which she had never experienced before. He immediately sent her to hospital for a CT scan as he suspected a cerebral (brain) bleed.
By the time she was examined by a fairly junior doctor the headache was settling a little and the brain scan was not performed. She was diagnosed as having migraine and sent home with painkillers.
Six days later she had a large bleed into the brain that left her severely disabled and with impaired vision. The hospital admitted liability and settled out of court for £400,000.
Clinical Negligence Case Study II
Mrs H, aged 54, who suffered an undiagnosed subarachnoid haemorrhage, developed a sudden pain of increasing severity in her head and neck while sitting quietly at home. She recognised it as being quite different from a normal headache, although she had no visual disturbance or neck stiffness.
She attended A&E where a raised blood pressure was noted and the diagnosis of simple headache made. Over the next 6 days her symptoms remained unchanged and during that time she was seen on 3 occasions by her own GP and the ‘out-of-hours’ GP service when hypertension and back pain were diagnosed. She also attended A&E for a second time (Day 6) when some neck stiffness was noted and a diagnosis of muscular neck pain made. No CT scan or lumbar puncture was performed.
8 days after the start of her symptoms Mrs H suddenly collapsed whilst in the company of her husband and was unresponsive on arrival at hospital. A CT scan revealed a massive subarachnoid haemorrhage (SAH) and she died the following day.
The claimant was Mrs H’s husband who alleged that had the correct diagnosis been made on either Day 1 or Day 6 when his wife attended A&E, she would have been referred for neurosurgery, and in all likelihood made a full recovery. This was not contested.
Following advice from a GP expert it was decided not to proceed against the GP or the ‘out of hours’ service. The Trust admitted that although Mrs H did not have the classical features of SAH, consideration should have been given to the possibility of this diagnosis at her first attendance at A&E given her age and the history of the onset of the headache.
When Mrs H attended A&E a second time, a diagnosis of SAH should again have been considered given the fact that she had had severe head pain for 5 days. It was admitted that at this stage she should have had a CT scan and possibly a lumbar puncture.
Mr H pursued a claim in his own right for compensation, having developed a very severe psychiatric injury as a result of witnessing the sudden collapse and death of his wife. He did not have classic symptoms of post-traumatic stress disorder but developed a major depressive disorder and an abnormal grief reaction.
The Claimant received £150,000 in respect of the claim of which £15,000 was for his own pain, suffering and loss of amenity.
