Brain Aneurysm Medical Negligence Lawyers – Compensation Claims

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Brain Aneurysm

A brain aneurysm is a ballooning out of a blood vessel inside the brain. The brain is supplied by four big blood vessels that join together to form the circle of Willis near the base of the brain. Wherever an artery joins another artery such as what happens in the circle of Willis, the junction can become weak and the artery can balloon out forming an aneurysm, which is a small sac. Most cerebral aneurysms cause no problems and are only found incidentally at the time of a person’s routine autopsy. If, on the other hand, they leak, they can cause a severe headache, symptoms similar to a stroke and possible death.

As mentioned, most brain aneurysms stem out of the circle of Willis that forms the junction of two carotid arteries and two vertebral arteries that supply all the nutrients and sugar to the brain. There are smaller branches sent upward and outward from the circle of Willis and everywhere there is a junction there is a weak spot. These outpouchings cause aneurysms that can break and bleed into the brain tissue.

There are a lot of causes of aneurysms, including atherosclerosis, trauma to the brain, high blood pressure, heredity and an unusual blood flow at the arterial junction. Rarer causes of brain aneurysms include mycotic aneurysms, caused by infections. Certain tumors can cause aneurysms and drug abuse with drugs like cocaine can inflame the walls of the artery, leading to aneurysm.

Brain aneurysms are found in at least 1 percent of people but most are small and carry no symptoms. Those that get large can push on brain tissue and lead to headache, numbness or weakness on the side of the face, a dilated pupil on one side of the head or a change in a person’s vision.

What’s worse is when the brain aneurysm ruptures or leaks into brain tissue. The individual can develop stroke symptoms and can even die from increased intracranial pressure. Blood can leak into the meninges, inflaming them and causing a subarachnoid hemorrhage.

The symptoms of a brain aneurysm are fairly straightforward. Many with a leaking aneurysm describe having “the worst headache of their life”. To be sure, the headache is severe as blood irritates the brain tissue. The headache is associated with a change in vision, nausea, and vomiting. If it spreads to become a subarachnoid hemorrhage, it can cause neck pain and stiffness of the neck. All of these symptoms together lead to an increased risk of a leaking aneurysm.

When all of the symptoms and physical exam are suspicious for a leaking aneurysm, the healthcare provider will order a CT scan of the head which shows a subarachnoid hemorrhage in greater than ninety percent of cases. A few might be too small to be seen on CT scan. In such cases, a lumbar puncture or spinal tap is done, which will show blood in the cerebrospinal fluid, running inside the subarachnoid space.

If there is evidence of blood in the lumbar puncture or on the CT scan, doctors will perform an angiogram of the head, which can localize the site of the aneurysm and the degree of bleeding. In this procedure, a small tube is passed into one of the arteries of the brain and dye is injected into the brain while x-ray pictures are taken. In some cases, CT angiography can be done to show a better three dimensional picture of the brain and the aneurysm. Sometimes an MRI is done in conjunction with an angiogram.

The differential diagnosis of a brain aneurysm includes the possibility of a migraine headache, bacterial or viral meningitis, a stroke, or a brain tumor. These can all mimic a brain aneurysm. The tests used will help decide what is going on so that the patient can be properly treated.

There are multiple treatments for aneurysms, especially those that are large but have not ruptured yet. The two main ways to treat these aneurysms are “clipping” of the aneurysm and “coiling” of the aneurysm. In clipping, the skull is opened up and the aneurysm identified. A clip is placed across the base of the aneurysm. There will be no further growth and no leakage after a clipping. A coiling procedure is newer than clipping. It involves threading a catheter into the brain. The catheter has coils of platinum wire unwound at the end of it. When the aneurysm is identified, the catheter allows the platinum wire to uncoil inside the aneurysm so that the blood inside it clots and the aneurysm never leaks.

The risks of both procedures include the possibility of damaging the blood vessel and resulting in more bleeding. Brain tissue can become damaged and the nearby vessels can go into spasm, resulting in a stroke. Doctors carefully monitor the vital signs to make sure there is no abnormal cardiac rhythm or high blood pressure. Patients are monitored for stroke-like symptoms, seizures, increased pain and agitation.

Brain aneurysms can have fatal outcomes. In fact, about ten percent of patients whose aneurysms have ruptured will die before receiving medical care. About half of all patients who never receive treatment are dead within a month and a quarter of all patients will have another bleed within a week. The risk of arterial spasm and stroke is very high, regardless of treatment. If the aneurysm is identified early and treated early, the survival rates are much better.

It is felt that patients who survive the initial event have ongoing problems secondary to vasospasm (blood vessel spasm). These people can develop stroke symptoms even when treated appropriately. New drugs are coming onto the market that will circumvent the vasospasm that is ongoing after repair. Antibodies may be identified that can blunt the effect of vasospasm. Because aneurysms are now felt to be hereditary, there may be screening of high risk individuals.

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