Stroke Malpractice
Brien Roche

Stroke: Ischemic or Hemorrhagic

Stroke (CVA – Cerebral Vascular Accident) is the fourth leading cause of adult death in the U.S. By 2030 nearly one in every 25 adults will suffer a stroke.

Most strokes can be grouped as either a bleed (hemorrhagic) or a blockage. Hemorrhagic strokes occur when a blood vessel ruptures. This releases blood into the tissue. Although most strokes are in the brain they can occur anywhere. In contrast an ischemic stroke is a blockage with reduced blood flow to the brain. Because 87% of all strokes are ischemic the medical focus is on those.

Stroke malpractice-Clots

Damage or narrowing to the internal wall of an artery leading to the brain can cause a clot. If the clot grows or a piece breaks off and travels to a smaller artery a blockage occurs. This decreases blood flow to the brain. These types of injuries can be from trauma to the neck or head. Also they can be from rapid twisting of the neck or head as in an auto crash.
A narrowing may be due to a build-up of fatty deposits inside the vessel or may be due to inflammation of the blood vessels.

Some strokes are from medication that causes clotting. When these clots form in or travel to an artery leading to the brain a stroke occurs.

A transient ischemic attack (TIA), also called a mini stroke, has the same symptoms as a stroke. However the symptoms go away quickly. They are a sign that a stroke is coming. One third of people who have a TIA later have a stroke. Half of patients who suffer a stroke after a TIA do so within 48 hours.

Symptoms

The basic signs of a stroke may be best recalled through the acronym, FAST:

F:  Facial drooping for face numbness which may be most often seen when the person attempts to smile.

A:  Arm weakness or numbness.

S:  Speech difficulty, in particular slurring.

T:  Time to call 911.

Other symptoms may include:

  • Having trouble finding the right words.
  • Weakness in a leg.
  • Trouble walking.
  • Trouble with coordination.
  • Trouble with vision.
  • Severe headache.
  • Confusion.
  • Dizziness

Treatment

The first line of treatment for a blockage is the use of the clot busting stroke drug known as tPA. Other treatment modes are the use of catheters inserted into the brain to remove the clot.  This is for people who are not receptive to tPA.  The risk of tPA is that it enhances the chance of bleeding. If the stroke is caused by a bleed then tPA makes things worse. Catheters are also used to seal a bleed.

Failure to timely treat a stroke is due to the failure to recognize or communicate its signs and symptoms. Prompt treatment restores blood flow. Stroke symptoms show themselves quickly when blood flow to the brain is interrupted. Fast treatment improves the chance of a better outcome. The American Stroke Association maintains a info campaign stating that time lost is brain lost. Call, or contact us for a free consult.

Stroke Malpractice-Investigation

In looking at stroke cases you need to define the hospital’s stroke certifications. In addition you need to look at their press releases and website info. You need to get the hospital policies and procedures pertaining to stroke. What are their criteria for activating a stroke code. What do they use to train personnel. In addition what are their standing orders on stroke treatment.

CT For Prompt Treatment

CT scanning is normally the first imaging done of a stroke patient. It is without contrast. This can be done quickly. It shows if there is a bleed. It can take up to 24 hours for a stroke to become visible on a plain, non-contrast CT. MRIs detect brain ischemia within minutes. However they are more often used to confirm the diagnosis. Brain scan images taken months after the stroke can be powerful exhibits. They show damaged brain tissue replaced with cerebral spinal fluid. Your experts must identify the parts of the body and bodily functions controlled by the area of the brain that the stroke damaged. Also these witnesses must confirm there is no evidence of pre-existing damage. In addition they must confirm there is no known therapy that will restore these functions.

The damages to be assessed are the loss of function, the effect on survivors, the cost of future care and future income loss.

The biggest danger of stroke is brain cell death.  Some of these brain cells can probably be saved if treated promptly.

Stroke Malpractice-Abdominal Aneurysm

If the bleed is in the abdominal area then frequently it is found in the abdominal aorta.  That is the body’s largest artery.  What happens with an artery like that is that it slowly bulges. Then it balloons. Finally it bursts.

Only 50% of the people in this condition live to reach an operating room.  Of those, there is a 90% mortality rate.  Every minute that passes increases that mortality rate by 1%.

Diagnosis

An aneurysm of this nature is tough to diagnose.  An EKG needs to be done to see if the patient has suffered a heart attack.  Pain and or swelling in the abdominal area may point to a ruptured aortic abdominal aneurysm.  That is confirmed with an ultrasound.  At that point the patient needs immediate transfusions.

Treatment

CPR must be given to prevent cardiac arrest.

Anesthesia causes the blood pressure to drop.  The surgeon needs to open the abdominal area and compress the aorta. The area of the bleed must be clamped. The aneurysm is then repaired.  Transfusions keep the patient alive with fresh blood.

The ruptured section of the aorta will be grafted which allows blood to pass through it normally.

The wound is left open since there is swelling.The open wound allows the swelling to occur without further problems.

Stroke Malpractice-Prevention

Ruptured abdominal aneurysms are preventable.  There is a 98% success when the aneurysm is detected by testing and repair through elective surgery.The risk factors are being over 60, having an immediate relative who had an abdominal aortic aneurysm, high blood pressure and smoking.

The best cure is prevention.  Medicare covers a one-time screening for these types of aneurysms.  If an aneurysm is detected that appears to be dangerous it can be repaired.

Call, or contact us for a free consult. Also for more information on medical malpractice see the other pages on the site. In addition for more information on stroke see also the pages on Wikipedia.

About Brien Roche Law

Brien Roche is an experienced medical malpractice attorney serving all of Northern Virginia, including Fairfax, McLean, Vienna, Burke, Annandale, Falls Church Reston, Centreville, Manassas, Alexandria, Herndon, Arlington, and Loudoun County.

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Brien Roche

Brien A. Roche has been an attorney since 1976. Mr. Roche is admitted to practice in Virginia, the District of Columbia, and Maryland. In addition to his busy law practice, Mr. Roche is also a published author of several books & articles relating to the practice of law.

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