At least one in 100 people go about their daily routine unaware
that they have potentially deadly flaws in the blood vessels of
their brain. These defects, known as berry aneurysms, are like tiny
balloons where the wall of the artery has thinned and weakened.
They're usually congenital - you're born with them - although
they may be the consequence of ageing or high blood pressure.
Berry aneurysms may burst if put under extra stress. The end
result is usually a subarachnoid haemorrhage or stroke.
Symptoms
There's often little or no warning that a subarachnoid
haemorrhage is about to occur. Typically, the person collapses with
a sudden headache unlike any they've experienced before. They may
vomit, develop signs of meningitis, such as neck stiffness and
dislike of light, and may rapidly become drowsy, confused and
unconscious.
In milder cases, the illness may appear like migraine or
meningitis due to an infection, but in severe cases it's quickly
apparent that something is seriously wrong.
Causes and risk factors
Fortunately, not every berry aneurysm ruptures - only about one
in 7,000 people have a subarachnoid haemorrhage. And not every
brain haemorrhage is due to a berry aneurysm. Although about 70 per
cent of subarachnoid haemorrhages are caused this way, no defect
can be found in at least ten per cent, and there are other types of
brain haemorrhage.
Not every stroke is due to a haemorrhage - the majority are
caused by blockages of the blood supply by a clot or
atherosclerosis.
A subarachnoid haemorrhage frequently occurs in young adults and
can often be fatal - as many as 30 per cent die within hours, and a
further 30 per cent die within the first month - or result in
serious disability in people who have young dependents.
There's a slight tendency for the problem to run in families.
Blood relations of someone who's had a subarachnoid haemorrhage
have a 14 per cent chance of having one, too. If you have two or
more relatives affected, some experts recommend you have special
screening tests of the blood vessels in your brain.
Women are more commonly affected than men, and people of African
origin are also at increased risk, possibly because they're more
likely to have high blood pressure. Children can have a stroke,
especially a subarachnoid haemorrhage.
Smoking and excessive alcohol intake are also linked to an
increased risk that a berry aneurysm will rupture.
Once a person reaches hospital, diagnosis is usually quickly
confirmed with a CT scan of the brain.
Treatment and recovery
Those who survive the initial episode are at a greater risk of
another bleed unless action is taken.
The standard treatment used to be surgery, which involves
opening the skull and clipping off the faulty blood vessel. This
operation, known as clipping, is usually done within days, but in
severe cases and the elderly it may be delayed for a few weeks.
Although the operation puts an end to the risk, it carries a risk
of damage (although this risk is far less than that of a second
bleed.)
In recent years, a new technique has been developed as an
alternative to clipping. Endovascular detachable-coil treatment,
(coiling) is where a detachable plantinum coil device is inserted
into the blood vessels via a small cut in the skin (usually in the
groin) and passed up into the brain under x-ray guidance to block
off the faulty vessel.
In 2005, a long-term follow-up study of patients treated with
coiling showed that it's as effective as surgery, has a lower risk
of complications and offers a greater chance of survival without
disability. It's now the standard treatment for most aneurysms in
most areas of the UK. Recovery from any type of stroke tends to be
slow. Intensive rehabilitation therapy, including physiotherapy,
speech therapy and occupational therapy are usually needed.
Depression is a common problem after stroke, and good psychological
and drug treatments are essential to help recovery.
After decades of being viewed as a fairly hopeless condition
where only a little positive treatment could be done, new
approaches are at last starting to make some impact on recovery
rates from strokes. For example, researchers have shown for the
first time in humans that rehabilitation therapy may help a stroke
survivor's brain rewire itself, leading to regained use of a
previously unused limb.
For further information on how MyInjuryLawyer can help with a
subarachnoid haemorrhage claim, please call us free on
0800 043 4299