Brain Aneurysm - Medical Negligence Claim


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A brain aneurysm is a small bulging area in a blood vessel within the brain. As it often looks like a berry, a brain aneurysm is often called a "berry aneurysm". Brain aneurysms can rupture or leak so that there is bleeding within the brain and in the subarachnoid space. Ruptured aneurysms are life threatening and need immediate treatment. Fortunately, most brain aneurysms do not rupture or cause any symptoms. These are found during other testing of the brain. In such cases, the treatment is directed toward not having the aneurysm rupture at all.

A ruptured aneurysm is easy to identify. It starts with a severe headache often described as the "worst headache a person has ever had". This is associated with nausea and vomiting, double vision, blurry vision, stiff neck, light sensitivity, drooping eyelids, seizures, confusion or coma. Sometimes an aneurysm just leaks a little bit and then dries up. This leads to some of the above symptoms that pass over time. Such symptoms should not be ignored.

If an aneurysm has not ruptured, there may be no symptoms. Large aneurysms of the brain can press on nerves or on brain tissue and can cause a dilated pupil, pain above or behind the eye, change in vision such as double vision, stroke-like symptoms or a drooping eyelid on one side.

The cause of brain aneurysms is not clear but they seem to run in families in some cases. Those who are older are at higher risk for developing a brain aneurysm as are those who smoke. Those with arteriosclerosis or hardening of the arteries are at greater risk of aneurysm. Cocaine use is associated with brain aneurysms and head injuries can cause rupture of brain aneurysms. Alcoholics are at greater risk for brain aneurysms and some blood infections trigger brain aneurysms. As mentioned, a family history of brain aneurysms put you at higher risk of having them, too.

Some genetic causes or birth defects that can increase the potential of having brain aneurysms include having connective tissue disorders like Ehlers-Danlos Syndrome, polycystic kidney disease, coarctation of the aorta or AVMs (arteriovenous malformations), which are abnormal connections between veins and arteries within the brain.

Complications of a ruptured aortic aneurysm include repetitive bleeding of the aneurysm, spasm of the blood vessels that can lead to a stroke, excess fluid on the brain known as hydrocephalus and low sodium, which is due to damage of the hypothalamus.

There are several tests that can determine if you have an aneurysm or a ruptured brain aneurysm. Such tests are done if there is suspicion of an aneurysm such as sudden severe headache and other symptoms. Tests for a ruptured brain aneurysm are about the same as for an un-ruptured brain aneurysm. A CT scan will show bleeding areas in the brain. It uses a dye that highlights the blood flow within the brain. This is called CT angiography. Tests of the cerebrospinal fluid might show blood in the cerebrospinal fluid from a subarachnoid hemorrhage. An MRI can show changes consistent with brain aneurysm. A cerebral angiogram is an x-ray test that uses a dye to show the entire vasculature of the brain so that any aneurysm is shown on the x-ray.

In some cases, there is screening for brain aneurysms. This occurs whenever there is a strong family history for brain aneurysms or if you have a medical condition or connective tissue disease that predisposes you to brain aneurysms.

Treatment for brain aneurysms includes two types of surgery. One is a surgery that uses a clip to block off the entrance to the aneurysm, thus making it bloodless so it dries up. No blood flows through a clipped aneurysm. Another type of surgery includes endovascular coiling. The surgeon puts a catheter into the artery and inserts a tiny coil into the aneurysm. The wire curls up inside the aneurysm, causing the blood to clot and the aneurysm to become clotted so it doesn't receive blood flow. It can be a risky procedure and it doesn't always work but it is far less invasive than clipping the aneurysm.

Other treatments include pain killers to kill the headache and calcium channel blocker medication to lower the blood pressure and reduce the amount of vasospasm around the aneurysm. An angioplasty can be done that will increase the blood flow around the aneurysm so spasm isn't much of a problem. Seizure medications are used to prevent seizure activity and certain shunts can be placed that decrease the pressure on the brain in cases of hydrocephalus.


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