In my law practice as a Houston, Texas medical malpractice attorney, I have had the opportunity of representing a number of clients who sought treatment for a terrible headache.
Any time I hear people say that they have the worst headache of their life, it gets my attention. When a doctor or nurse hears a patient say the same thing, the standard of care requires them to act quickly to rule out or treat some potential life-threatening injuries.
This brings to mind the case of a 50-year-old man who suddenly experienced a severe headache and went to the emergency room at a hospital. He told the physician assistant and nursing staff about his headache, as well as neck pain and stiffness, disorientation, and vomiting.
The physician assistant diagnosed him with a headache caused by dehydration. He gave the patient pain medication, IV fluids, and discharged him.
What is a brain aneurysm?
A brain aneurysm is a weak spot on the wall of a brain artery that bulges out. Also called a cerebral aneurysm or intracranial aneurysm, a brain aneurysm develops over time as blood flow pounding against the weakened portion of the artery causes the vessel wall to erode from wear and tear. Eventually, the blood vessel becomes so damaged that the weak spot swells and bulges out.
If the aneurysm ruptures, blood escapes into the space around the brain, which is an emergency situation. Aneurysms account for around 3-5% of all new strokes.
Generally speaking, there are two types of aneurysms.
The first type is a saccular aneurysm. About 80-90% of all brain aneurysms not caused by trauma. Saccular aneurysms are the most common cause for subarachnoid hemorrhage, which means a brain bleed going into the subarachnoid space.
The second type is a fusiform aneurysm, which is less common. Fusiform aneurysms bulge out on both sides of an artery, meaning that the vessels expanded in all directions. These aneurysms rarely rupture.
Experts believe that around 6 million Americans have an unruptured brain aneurysm. Each year, about 30,000 people in the United States have a brain aneurysm rupture.
Who is at risk?
Brain aneurysms are most common among people who are aged 35-60, with most of them developing after the age of 40. Women, African-Americans, and Hispanics have a higher risk for aneurysms.
Brain aneurysm signs and symptoms
Unfortunately for the patient, the physician assistant overlooked some of the classic, textbook signs and symptoms of a brain aneurysm. The
recommends seeing a doctor immediately if you experience some or all of the symptoms:
· A sudden severe headache, the worst headache of your life
· Nausea or vomiting
· A stiff neck
· Loss of consciousness
· Sudden blurred or double vision
· Sudden pain above or behind the eye, or difficulty seeing
· Sudden change in mental status or awareness
· Sudden trouble walking or dizziness
· Sudden weakness and numbness
· Sensitivity to light (also called photophobia)
· Drooping eyelid
Migraines and headaches are common, but with these signs and symptoms, doctors and mid-level providers (like physician assistants and nurse practitioners) need to do a full workup to rule out the dangerous condition of a brain aneurysm. Medical research shows that at least 20% of brain aneurysms leak before they rupture. The leaking blood causes the sudden onset of a terrible headache.
As a result of the physician assistant’s misdiagnosis, the patient went home untreated and, two days later, collapsed from a stroke caused by a ruptured cerebral aneurysm. Before he could get back to the hospital, he had two separate episodes of cardiac arrest (heart attack).
For patients arriving at an emergency room with brain aneurysm symptoms, the standard of care requires an order for a CT scan of the head, as well as further workup.
Treatment of brain aneurysms
Treatment options for brain aneurysm very dependent whether the aneurysm ruptured.
For unruptured aneurysms, the standard of care allows doctors to consider either treatment or observation.
Once an aneurysm has ruptured, though, the options are either an open surgery or a less-invasive endovascular procedure. Experts recommend the surgery or procedure as quickly as possible to prevent a re-bleed from developing by using a clip or coil to seal off the aneurysm.
We are here to help
If you or a loved one has been seriously injured as result of a misdiagnosed or mistreated aneurysm, call the experienced medical malpractice lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical malpractice and wrongful death lawsuits against hospitals, surgeons, doctors, and other healthcare providers. In 2017, he was named among Houston’s top lawyers by H Texas magazine.