What is a Hemorrhagic Stroke?

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There are two types of strokes: Ischemic (“dry stroke”) and Hemorrhagic (“bleeding stroke”). 87% of all strokes are ischemic strokes. Hemorrhagic strokes account for the remaining 13 percent of stroke cases. An ischemic stroke occurs when blood flow to the brain is restricted by a clot in an blood vessel. A hemorrhagic stroke, on the other hand, occurs when there is bleeding that occurs within the skull. The blood accumulates and compresses the surrounding brain tissue.

Either type of stroke can cause permanent, life threatening injuries and may even cause death without emergency treatment. While some people will unfortunately suffer a stroke no matter how good the medical care is, other bad outcomes may be caused by a medical error, mistake, or even physician or hospital negligence.

If you are recovering from a stroke, you should investigate whether your stroke was caused by a medical error. Begin your investigation by contacting a stroke malpractice lawyer.

What Are the Different Types of Hemorrhagic Stroke?

There are two types of hemorrhagic strokes. The two types of hemorrhagic strokes are intracerebral (within the brain) hemorrhage or subarachnoid (outside the brain) hemorrhage. The major difference between an intracerebral hemorrhage and a subachnoid hemorrhage is where inside the skull the bleeding occurs.

All strokes are medical emergencies that require immediate medical treatment.

A photo of a brain with a subachnoid hemorrhage and an intracerebal hemorrhage, possibly because of medical malpractice.

A subarachnoid hemorrhage occurs in the space between the skull and the brain. An intracerebral hemorrage occurs within the brain tissue. Either can be caused can be caused or made worse because of a medical or hospital mistake or negligence.

What Causes Bleeding In The Brain in First Place?

Generally speaking, there are two reasons for a hemorrhagic or bleeding stroke. One reason is a ruptured brain aneurysm. The other reason is an arteriovenous malformation. Either one can be life threatening and cause severe injuries if not recognized early and treated immediately.

Cerebral Aneurysm

What is a Brain Aneurysm?

An aneurysm is a weak area in a blood vessel. The weak point in the blood vessel usually enlarges over time – much like a weak spot in a garden hose.  The aneurysm is often described as a “ballooning” of the blood vessel.

A cerebral aneurysm is often called a brain aneurysm because it occurs in one of the blood vessels in the brain. If the aneurysm ruptures, it can cause catastrophic and deadly results.

Are Aneurysms Common?

Brain aneurysms are more common than you might think. Between 1.5 to 5% of the U.S. population will develop a brain aneurysm at some point during their lifetime. Most people who have brain aneurysms do not have any symptoms. Of the 3 to 5 million people in the U.S. who have brain aneurysms, only a small fraction have any symptoms. Only around .5 to 3% of people who have brain aneurysms will go on to experience bleeding in the brain.

It is important for doctors and hospital to determine which of those patients are likely to experience bleeding in order to treat them.

How do Brain Aneurysms Form? Are People Born with Brain Aneurysms?

It is rare to have an aneurysm at birth. Most brain aneurysms develop after a person reaches 40 years of age. Brain aneurysms usually develop at places where there is constant pressure from blood flow. They usually develop slowly and grow over time. As the aneurysm grows, the tissue of the artery stretches. Like a balloon, as the area grows and stretches it becomes weaker. 

While people usually are not born with an aneurysm, a person may inherit a tendency to form aneurysms. Aneurysms can also develop because of aging and health conditions commonly associated with aging, like hardening of the arteries.

What are the Risk Factors for Developing a Brain Aneurysm?

There are also risk factors that make it more likely to develop an aneurysm. Some of those risk factors can be controlled, but some of them cannot. The following is a list of risk factors make it more likely that you will develop an aneurysm. If you have had an aneurysm in the past, these risk factors make it more likely that your aneurysm will rupture.

  • Gender – For reasons that are not completely known, women are more likely to have a brain aneurysm and a subarachnoid hemorrhage.
  • Race – African Americans are more likely to develop a subarachnoid hemorrhage than their white peers. There are multiple reasons that African Americans are more likely to have a subarachnoid hemorrhage than whites. One reason is that Blacks on average suffer from conditions that predispose them to stroke at a higher rate than other races, including high blood pressure, obesity, high cholesteral and diabetes. Also some people of African descent may be genetically predisposed to having a subarachnoid hemorrhage. For more information about minorities and stroke malpractice, click here.
  • Previous Aneurysm – People who have already had a brain aneurysm are more likely to develop another brain aneurysm.
  • Family History – If you have a family history of brain aneurysms, you are more likely to develop a brain aneurysm.
  • High Blood Pressure – High blood pressure is a major risk factor for developing a subarachnoid hemorrhage.
  • Smoking – Smoking is a risk factor for two reasons. First, smoking increases the risk of high blood pressure. Second, smoking increases the risk that a brain aneurysm will rupture.

It is important that doctors and hospitals gather all of the available information about a patient in order to provide the best treatment for the patient. An accurate history is important to identify who is at risk for developing an aneurysm and what treatment is needed for the aneurysm. If a physician does not take these risk factors into consideration and a stroke occurs, it should be investigated whether the doctor or hospital was negligent.

Are Some Aneurysms More Dangerous Than Others?

Brain aneurysms are all different. They vary in sizes and shape.

Size
  • Small aneurysms are less than 5 mm (1/4 inch)
  • Medium aneurysms are 6–15 mm (1/4 to 3/4 inch)
  • Large aneurysms are 16–25 mm (3/4 to 1 1/4 inch)
  • Giant aneurysms are larger than 25 mm (1 1/4 inch)
Shape

Aneurysms can be:

  • Saccular aneurysm 
  • Fusiform aneurysm 
  • Ruptured aneurysm
A ruptured brain aneurysm, possibly due to medical malpractice.

There are different shapes and sizes of brain aneurysms, but they all should be treated to prevent injury. 

How Does A Doctor Diagnose An Aneurysm?

An aneurysm cannot be seen with the naked eye or through a physical examination. Special imaging tests are needed to diagnose a brain aneurysm. These are sophisticated tests that look at blood vessels in the brain. There are 3 tests that can be performed to look for an aneurysm.

Computed Tomographic Angiography

This test is also commonly called a CTA. A patient is placed on a table. The slides into a scanning machine. A special dye called contrast  is injected into a vein. Images are taken of the blood vessels to look for abnormalities. These images are precise enough to detect an aneurysm.

Magnetic Resonance Angiography

This test is also commonly called a MRA. A patients is placed on a table. The table slides into a scanner. Images are taken, and those images can show abnormalities in a blood vessel, including an aneurysm.  that slides into a magnetic resonance scanner, and the blood vessels are imaged to detect a cerebral aneurysm.

A CTA and MRA can detect most brain aneurysms larger than 3–5 mm (about 3/16 inch). They are not precise enough to detect smaller aneurysms.

Cerebral Angiogram

A diagnostic cerebral angiogram is the most reliable test to find an aneurysm. A patient lies on a table. A small tube (catheter) is inserted through a blood vessel in the leg (groin). The catheter is guided into each of the blood vessels in the neck that go to the brain. Dye is injected into the patient’s blood stream. Pictures are taken of all the blood vessels in the brain.

This test is most reliable way to detect all types and sizes of cerebral aneurysms.

A diagnostic cerebral angiogram is usually performed to fully map a plan for therapy before any type of treatment is considered.

If one aneurysm forms, will others form?

One of the major risk factors for developing an aneurysm is a history of at least one prior aneurysm. If you had an aneurysm, there is a 15-20% chance that you will develop another one.

Do Unruptured Aneurysms Have Symptoms?

Most smaller aneurysms do not have any symptoms. As an aneurysm grows, it can produce severe headaches or localized pain. A recurring headache in a specific part of the head may be a sign of an aneurysm.  If an aneurysm gets very large, it will put pressure on the nerves surrounding the brain. The increased pressure can cause sensory changes like numbness or weakness in arms and legs, changes in memory and speech, seizures, or vision changes. 

These are each signs that should be discussed with your doctor. Your doctor should act on these symptoms. If the aneurysm continues to grow, it can rupture and cause permanent injuries or death. If this happens, you should have your case investigated by a stroke medical malpractice lawyer. 

What Causes an Aneurysm to Rupture?

It is difficult to predict exactly when an aneurysm will rupture or exactly what caused it to rupture. What we do know is there that conditions that increase the likelihood that an aneurysm will rupture. These risk factors include:

High Blood Pressure

High blood pressure, also called hypertension, is the leading cause of subarachnoid hemorrhage. High blood pressure is also a leading causing of ischemic or dry stroke, which is the most common kind of stroke. Doctors need to work with patients to lower blood pressure to avoid all kinds of stroke. This includes helping patients reduce their blood pressure through a healthy lifestyle or even medications.

Some activities can cause the blood pressure to spike. Some of these activities include heavy lifting or straining. When this happens, extra pressure is placed on the blood vessel, and it can rupture.

Stress

A strong emotional stress response can cause blood pressure to spike. Like other things that cause the blood pressure to rise, a strong emotional response because or anger or grief can cause an aneurysm to rupture.

Blood Thinners

Many people take medications called blood thinners for one reason or another. Some of these medications are by prescription only, like warfarin or coumadin. Stimulants like diet pills (including ephedrine and amphetamines) can the blood. Some harmful drugs like cocaine can cause aneurysms to rupture. Other medications that thin blood can be over the counter like aspirin.

Doctors who are prescribing blood thinners to patients need to be careful not to excessively increase a patient’s risk of a brain bleed. If a doctor or hospital acts unreasonably by providing too much blood thinner to a patient and the patient has a stroke, it may be medical negligence and should be investigated by a stroke medical malpractice lawyer.

Does Anything Increases the Chance that an Aneurysm will Rupture?

Many factors affect whether an aneurysm will rupture. These factors include the location, shape, and size of the aneurysm. Other factors to consider are whether the aneurysm is causing symptoms. Larger aneurysms are more likely to rupture than smaller ones.

If an aneurysm does begin to bleed, emergency medical treatment is needed.

An emergency room where a patient will be treated for stroke, possibly because of medical malpractice.

Although it is well-known that strokes are medical emergency, patients often get delayed stroke treatment.

What happens if an aneurysm bleeds?

If an aneurysm ruptures, blood can leak into the area around the brain.  This is called a “subarachnoid hemorrhage.” Because the brain sits inside of a fixed container (the skull), there is nowhere for the brain to go as blood is introduced. If enough blood enters the area between the skull and brain, it can crush the brain through a process called herniation. This usually results in death. 

The severity of the symptoms depend on the amount of blood that is collecting around the brain. The symptoms can include the following:

  • Severe headache
  • Nausea and vomiting
  • Sleepiness that can lead to coma
  • Death

If the vessel that begins to bleed is in the brain itself, it is called an intracerebral hemorrhage. When people desribe a “hemorrhagic stroke,” they are usually referring to an intracerebral hemorrhage. When this happens, the bleeding within the brain can cause permanent disabilities or death. The blood itself  can be harmful. Also, just as the amount of blood in the brain increases, it can damage important brain structures and death through brain herniation.

This can lead to:

  • Weakness or paralysis of parts of the body
  • Difficulty speaking or understanding language
  • Vision changes
  • Seizures
  • Death

What Happens if There is a Delayed Diagnosis or Misdiagnosis of Stroke?

In order to have the best chance of recovery, it is important that patients get diagnosed and treated as soon as possible. A delayed diagnosis or a misdiagnosis of stroke can cause serious permanent injuries or death. Unfortunately, a misdiagnosis or a delayed diagnosis of stroke can occur. If a patient has had a delayed diagnosis or misdiagnosis of a stroke, they should have the case investigated by a stroke malpractice lawyer.

A patient is rushed into the ER after a stroke, perhaps because of a delayed diagnosis or misdiagnosis of stroke

Although strokes are medical emergency, many patients get delayed stroke treatment.

What Kind of Damage is Caused by A Ruptured Brain Aneurysm?

When an aneurysm bleeds, injuries happen. If immediate treatment is not provided, the ruptured aneurysm can cause additional brain bleeds. 

The chance of death increases to 30 to 40% after an aneurysm ruptures. There is a 20 to 35% chance of severe brain damage after an aneurysm ruptures, and this is after medical treatment is provided. Another 15-30% of people will go on to experience mild disabilities.

There are a host of injuries that can occur following a ruptured aneurysm. These injuries include:

  • Vision Problems;
  • Shoulder Pain;
  • Difficulty Swallowing (Dysphagia);
  • Difficulty Expressing or Recalling Language (Expressive and Receptive Aphasia);
  • Central Post-Post Stroke Pain Syndrome;
  • Claw-toe and Hammertoe;
  • Poor Balance;
  • Weakness;
  • Incontinence;
  • Flacidity;
  • Spasticity;
  • Poor Motor Skills; and
  • Fatigue

For more information about the types of harms that can be caused by a stroke, visit Life After Stroke.

Will Treating a Ruptured Aneurysm Improve Brain Damage?

Unfortunately, it won’t. Once an aneurysm ruptures and causes brain damage, it is permanent. There is nothing that can be done to reverse the brain damage once it occurs. Treatment can be provided to prevent more bleeding from happening in the future. This will decrease the chance of additional brain damage from further bleeding.

Because the brain damage is irreversible, it is important for doctors and hospital to treat the aneurysm before it ruptures.

If an Aneurysm Has Caused Brain Damage, Is There Anything that can be Done to Improve Function?

Patients who experience brain damage from a stroke may benefit from rehabilitation therapy. These can include physical, occupational, speech, respiratory, and aquatic therapy. For more information about the types of therapy than can help following a stroke, visit Life After Stroke. Because stroke rehabilitation therapy is very expensive, one of the only ways that many patients can pay is by filing a medical malpractice lawsuit related to the stroke.

Who Decides How to Treat An Aneurysm?

Every patient is different, and every aneurysm is different. Doctors must decide what treatment is best for the patient. To make this decision, doctors must carefully analyze the risks and benefits of treatment and no treatment. Doctors must also decide what treatment is safest for the patient.

Not all physicians treat aneurysms. There are experts in the field called specialists who have received special training about howto treat an aneurysm. These usually one or more of the following doctors:

  • A neurosurgeon with endovascular expertise and training;
  • A cerebrovascular neurosurgeon with expertise in surgically clipping aneurysms; 
  • A neurointerventionalist (a neurologist with endovascular training); and/or 
  • A neuroradiologist who specializes in the less invasive treatment of cerebral aneurysms by coiling.

These medical specialists have different training and backgrounds.

How Should an Aneurysm be Treated?

The appropriate treatment depends on whether the aneurysm has ruptured or not. A rupture aneurysm is a medical emergency. There should be no delay in diagnosis or treatment. If there is a misdiagnosis or a delayed diagnosis, this will seriously jeopardize the health and safety of the patient. It may be grounds for a medical malpractice lawsuit related to stroke. Keep in mind that the treatment options depend on the location and size of the aneurysm. The patient’s medical condition at the time also plays a role in which treatment to use. 

If an aneurysm is still in tact and has not begun to bleed, the treatment will depend on the patient’s symptoms, as well as the location, size, and shape of the aneurysm. 

In deciding what is the best treatment available, you should consult with a neurosurgeon, neurointerventionalist, or neuroradiologist with extensive experience in treatment brain aneurysms.

What treatments are available?

Medical therapy

If a patient has a small aneurysm that has not ruptured, surgical treatment can sometimes be delayed. However, it is crucial that the patient be regularly examined with checkups to make sure that the aneurysm is not growing and is not likely to rupture. These checkups include monitoring blood pressure, cholesterol, and any medications – like blood thinners – than can increase the risk of a rupture. Also, the patient should receive regular imaging to make sure that the aneurysm is not growing or changing.

If a doctor is aware that a patient has an aneurysm but does not follow these standards, the aneurysm can rupture and cause serious injury. The patient or someone on the patient’s behalf may need to file a lawsuit for medical malpractice because of the untreated aneurysm.

Neurosurgery

Aneurysms can be treated with a traditional surgery where a portion of the skull is temporarily removed to provide access to the brain. This procedure is performed by a cerebrovascular neurosurgeon. The patient is anesthesized. An opening is made in the skull. Th neurosurgeon accesses the brain and spreads it apart. The aneurysm is exposed and the surgeon places a clip on the aneurysm.  The clips creates a seal preventing blood from entering the aneurysm. This works to prevent the aneurysm from growing and rupturing or creating more bleeding. 

A doctor or hospital has clipped an aneurysm to avoid medical malpractice.

A brain aneurysm has been clipped to prevent rupture and a hemorrhagic stroke.

Endovascular Treatment

Endovascular treatment is sometimes called endovascular surgery, but it is not surgery in the traditional sense. Unlike traditional surgeries where the patient is cut open, endovascular treatment is performed from inside the blood vessel. In many ways, the treatment is similar to that of cerebral angiogram. The major difference is that instead of taking pictures of the blood vessel, the doctor places tiny platinum coils in the aneurysm. The doctor then releases the coil, and it remains in the aneurysm. The coil will remain in the aneurysm indefinitely where it will act as a barrier preventing blood from flowing into the aneurysm.

A physician has coiled a brain aneurysm, which is needed to avoid medical malpractice.

Brain aneurysms can be coiled to prevent rupture.

Can I File a Medical Malpractice Lawsuit for a Brain Aneurysm?

Yes. A lawsuit for a brain aneurysm just is like any other medical condition. If a doctor or hospital was negligent in diagnosing or treating a brain aneurysm and it caused an injury, a medical malpractice lawsuit should be investigated. If you would like us to investigate your potential brain aneurysm lawsuit related, you will need to act quickly. There are short time restrictions for filing a lawsuit for medical malpractice, including for a brain aneurysm that has caused bleeding in the brain.

To begin your investigation, please complete the contact information form at the bottom of the page, which will allow us to begin investigating your case. You can also call us at 216-777-8856 and we will gather the information needed to begin investigating your lawsuit related to a brain aneurysm.

Arteriovenous Malformation

What is a Brain Arteriovenous Malformation?

Arteries take oxygen rich blood from the heart to the brain. Veins do the opposite. Veins carry oxygen depleted blood away from the brain and back to the heart. An arteriovenous malformation disrupts this usual process.

An arteriovenous malformation occurs when there a tangle of blood vessels either on the surface of the brain in the brain tissue. Rather than deliver the oxygen rich blood to the brain, the malformation diverts from the blood back into a vein.

Are Brain Arteriovenous Malformations Common?

Not in the way that we usually think of things as being common. They occur in less than 1% of the population. That means that only around 1 in every 250 to 500 people have an arteriovenous malformation. But there are certainly populations who are much more likely to have an arteriovenous malformation, particular men.

What Causes a Brain Arteriovenous Malformation?

There are many different reasons that people may develop an arteriovenous malformation. For some people, they are congenital. This means that they were born with the condition because it was formed during fetal development.

For other people, they are acquired, meaning they develop the condition after birth. Sometimes they can be caused by head trauma, such as an assault.

There are certain risk factors for developing an ateriovenous malformation. These include gender (men are more likely to develop AVMs) and a family history of arteriovenous malformations.

Where Do Arteriovenous Malformations Occur?

Arteriovenous malformation can occur anywhere in the body, but they are most likely to occur in the brain or neck. When they do occur in the brain

Brain AVMs can occur anywhere within the brain or on its covering. This includes the four major lobes of the front part of the brain (frontal, parietal, temporal, occipital), the back part of the brain (cerebellum), the brainstem, or the ventricles (deep spaces within the brain that produce and circulate the cerebrospinal fluid).

What are the Signs and Symptoms of a Brain Arteriovenous Malformation?

Not all brain AVMs have the same symptoms. Much of the symptoms depend on the location and severity of the brain AVM.

  • More than 50 percent of patients with a brain AVM have some bleeding within the skull (called an  intracranial hemorrhage); 
  • Around 25% of patients with a brain AVM suffer from some sort of seizures; 
  • Some patients experience headaches in a particular part of the brain. This is due to an increase of blood flow around the brain AVM;
  • About 15% of patients with a brain AVM may have problems with vision (including double vision), speech (including slurred speech and difficulty remember or finding words), and movement (including difficulty walking, moving arms, shakiness, and any abnormalities of strength or sensation in the legs or arms).

What Complications Can Be Caused by a Brain Arteriovenous Fistula?

A brain AVM can cause many complications. Some of these complications include:

Bleeding in the Brain (Intracerebral Hemorrhage)
  • A brain AVM puts unusual pressure on the walls of the arteries and veins that are affected by the AVM. This causes the walls of the veins and arteries to become weak and thin. The wall of the vein or artery can become so weak that it ruptures. This causes bleeding in the brain (intracerebral hemorrhage) or outside of the brain.
  • Some brain bleeds may be so small that they go undetected. Other brain bleeds are life threatening.
  • Around 2% percent of hemorrhagic strokes are caused by brain AVMs. They are fequently the cause of brain hemorrhages in children and young adults.
Reduced Oxygen to the Brain
  • When a person has a brain AVM, blood goes directly from arteries to veins. This means that oxygen rich blood is never delivered to parts of brain tissue. Without enough oxygen, brain tissue suffers. It can become weak or it can die off altogether. When the brain tissue is weakened or dies because of a lack of blood flow, the person will being to have stroke-like symptoms. These symptoms can include numbness, vision changes or vision loss, weakness, unsteadiness on one’s feet, and difficulty speaking. Depending on how long the brain is deprived of oxygen, these symptoms can be permanent.
Thin or Weakened Blood Vessels
  • A brain arteriovenous malformation places a lot of pressure on the walls of the blood vessel. The extra pressure can cause the blood vessel to bulge. The bulge in the blood vessel wall is called a brain aneurysm. The brain aneurysm can rupture without treatment causing bleeding in the brain (intracerebral hemorrhage) or in the space outside of the brain (subarachnoid hemorrhage). When a brain aneurysm ruptures, the damage it causes can be irreversible.
Brain Damage
  • As a person’s body grows, more blood is required to supply oxygen to the different areas. Because the arteries are not functioning properly, the body can cause more arteries to help supply the blood malformation. The brain AVM can also grow in size. It can become so large that it places pressure on and actually begins to compress important parts of the brain. The brain is coated in a special protective fluid called cerebrospinal fluid. When the cerebrospinal fluid cannot freely travel around all areas of the brain, the fluid begins to build up in the skull. Because the skull is a fixed container, there is nowhere for this extra fluid to go. As the fluid increases within the skull, it pushes the brain tissue against the skull because of something called hydrocephalus.
  • If the hydrocephalus gets bad enough, it can crush the brain through a process called herniation. This almost always causes brain death.

What are the Different Types of Brain AVMs?

Yes, there are different types of aterivenous malformations that occur in the brain. All blood vessel malformations involving the brain and its surrounding structures are commonly referred to as AVMs. But several types exist:

True Arteriovenous Malformation (AVM)

These are the most common  types vascular malformations in the brain. A true AVM involves a tangle of abnormal blood vessels that are connected to and arteries.  There is no normal brain tissue that runs between the AVM.

Occult or Cryptic Arteriovenous Malformation (AVM) or Cavernous Malformations

These are malformations, but they do not displace or channel large amounts of blood. Rather, they tend to bleed often. They may also produce seizures.

Venous Malformation

Arteriovenous malformations (AVMs) include both arteries and veins. Venous malformations include only veins.

Hemangiblastoma

A hemangioma is an abnormal buildup of blood vessels in the skin or internal organs. They form a kind of tumor. They can occur on the brain. There are two kinds of hemangiomas, but only hemangioblastomas occur in the brain.  These tumors are benign (not cancerous), well defined, and grow slowly. These are by far the most common types of hemangiomas. The most common symptoms of hemangioblastoma include difficulty walking, poor coordination of arms and legs, nausea, vomiting, and headache.

They are usually found in the lowest part of the brain. This can be very close to the brain stem or even attached to the brain stem.  However, they can also occur in the retina, spinal cord, and cerebral hemispheres.

Surgery is the standard treatment for a hemangioblastoma. If the tumor cannot be removed entirely or it is attached to the brain stem, it can be treated with stereotactic radiation.

Dural fistula

The brain is covered in a thin sheath like material called the “dura mater.” There are blood vessels that contained in this sheath that surrounds the brain. An abnormal connection between blood vessels that involve only this covering is called a dural-based fistula. Because this sheath covers the entire brain, dural fistulas can occur anywhere around the brain. There are three kinds of dural-based fistulas, and each has distinct symptoms. 

Sagittal Sinus and Scalp Dural Fistula

This type of fistula occurs in the sheath surrounding the brain at the top of the head. The warning signs for this type of fistula include noise complaints (this is called bruit). Patients can actually hear noise being made in the skull by the fistula because it is somewhat close to the ear. These patients also get pain near the top of their head, headaches, and they may have large blood vessel on the scalp and above the ear.

Dural Carotid Cavernous Sinus Fistula

These kinds of fistulas are located behind the eye. They usually cause symptoms by forcing too much blood toward the eye. Symptoms of this kind of fistula include decreased vision, eye swelling, eye congestion, and eye redness. These patients can often hear a “swooshing” noise caused by the abnormal blood flow. 

Transverse-Sigmoid Sinus Dural Fistula

These kinds of fistulas occur behind the ear. Patients frequently complain of hearing a ongoing noise (called a bruit). The noise occurs each time the heart beats. These patients also have neck pain, headaches, and pain behind the ear. 

How are Dural Fistulas Treated?

The most successful treatment is usually by blocking of the abnormal connections between the blood vessel. This involves guiding small tubes called catheters inside the blood vessel. Doctors use with X-rays to know where the catheters are at any given time. Many times – depending on the exact size and location – these can be treated using these techniques. 

How are AVMs diagnosed?

Most AVMs are detected with either a computed tomography (CT) brain scan or a magnetic resonance imaging (MRI) brain scan. These tests are very good at detecting brain AVMs. They also provide information about the location and size of the AVM and whether it may have bled. A doctor may also perform a cerebral angiogram. This test involves inserting a catheter (small tube) through an artery in the leg (groin). Then it’s guided into each of the vessels in the neck going to the brain, and a contrast material (dye) is injected and pictures are taken of all the blood vessels in the brain. For any type of treatment involving an AVM, an angiogram may be needed to better identify the type of AVM.

What different types of treatment are available?

Medical therapy

Sometimes if there are no symptoms and the arteriovenous malformation is in an area of the brain that is very difficult to treat, the most conservative approach is something called medical management. Medical management involves closely monitoring the patient to make sure that the AVM does not get worse or become dangerous. This includes regular checkups with a neurologist and/or a neurosurgeon. It is also requires avoiding anything that can increase the risk of bleeding. These include avoiding activities that cause blood pressure to become elevated and treating high blood pressure (hypertension). It also requires avoiding blood thinners like warfarin, heparin, lovenox, or eliquis.

Surgery

If an AVM has bled and/or is in an area that can be easily operated upon, then surgical removal may be recommended. The patient is put to sleep with anesthesia, a portion of the skull is removed, and the AVM is surgically removed. When the AVM is completely taken out, the possibility of any further bleeding should be eliminated.

Stereotactic Radiosurgery

Stereotactic radiosurgery is not surgery at all, despite the name. Rather, stereotactic radiosurgery is a kind of intense radiation that is delivered to a small part of the brain. Its most well-known use is gammaknife or cyberknife technology in cancer treatment for brain tumors.

If a brain AVM is not too big, this same technology can be used. How can radiation fix an AVM? The radiation beam is directly at the brain AVM. The radiation injures the vessels and causes them become scarred with a small amount of scar tissue. The scar tissue acts to seal the vessel and prevents the blood from flowing in the wrong course.

Endovascular Neurosurgery / Interventional Neuroradiology

It is possible to treat an AVM in the brain using what is called endovascular surgery. This is also sometimes called interventional neuroradiology. A small tube called a catheter is placed inside of a blood vessel that is supplying blood to the AVM. Then some material is inserted through the catheter. Liquid adhesives (a special glue), particles, or microcoils are inserted into the area to prevent the blood from flowing improperly.

Are There Certain Kinds of Doctors Who Specialize in Treating Arteriovenous Malformations?

Yes. Arteriovenous malformations in the brain are complicated and treated by doctors who specialists in this field. These doctors include:

  • Endovascular Neorsugeons / Interventional Neuroradiologists – These are doctors who have received special training in performing endovascular procedures. Unlike traditional surgeries, these are procedures that are performed using tools that are placed inside of the arteries and veins.
  • Stroke Neurologists – These are doctors who not only specialize in diseases of the neurological system (neurologists) but who specialize in stroke. While these doctors do not perform the procedures to remove the arteriovenous malformation, they are able to diagnose, monitor, and decide what treatment is needed for the brain AVM.
  • Neuroradiologists – radiologists use diagnostic imaging (like CT, CTA, MRI, MRA, and x-ray) to look at areas of the brain. Neuroradiologists specialize in the diagnosis and imaging of the head, neck, brain, and spinal cord.
  • Vascular Neurosurgeons – These are doctors who specialize in surgically removing brain AVMs.
  • Radiation Therapsist and Neursurgeons who specialize in performing procedures called stereotactic radiosurgery to remove AVMs that occur in the brain.

Can I File A Medical Malpractice Lawsuit for a Brain Arteriovenous Malformation (AVM)?

Yes. A lawsuit for a brain arteriovenous malformation (AVM) just is like any other medical condition. If you think that a doctor or hospital was negligent in diagnosing or treating a brain ateriovenous malformation (AVM) and it caused an injury, a medical malpractice or negligence lawsuit should be investigated. If you would like us to investigate your potential brain arteriovenous malformation (AVM) lawsuit, you will need to act quickly. There are short time restrictions for filing a lawsuit for medical malpractice or negligence, including for a brain arteriovenous malformation (AVM).

To begin your investigation, please complete the contact information form at the bottom of the page, which will allow us to begin investigating your case. You can also call us at 216-777-8856 and we will gather the information needed to begin investigating your lawsuit related to a brain arteriovenous malformation (AVM).

How do I Hire You to be My Hemorrhagic Stroke Malpractice Lawyer?

The first thing you should do is complete the contact information form, which will allow us to begin investigating your case. You can call us at 216-777-8856 and we will begin gathering the information needed to begin investigating your medical malpractice and negligence lawsuit related to a hemorrhagic (“bleeding”) stroke.

Once we’ve investigated, we’ll candidly tell you what we think about what happened, whether the medical provider is to blame, and what we think about the strength of the case.

Which means when we do take on a case, our reputation tells the other side this is a serious case we believe in.

If for whatever reason we do not take on the case, and we think there is some merit to the case, we’ll try and help you find a lawyer who might take it on.

If you would like more information about us, you can visit us at Eadie Hill Trial Lawyers.

Michael Hill

Michael Hill

Trial Lawyer at Eadie Hill Trial Lawyers
Michael Hill is an accomplished trial lawyer focusing on representing individuals who have suffered life changing injuries due to stroke. While Michael resides in Cleveland, Ohio, he handles stroke medical malpractice cases throughout the United States.

Michael Hill has recorded several seven figure verdicts and settlements.Michael is a regular speaker for lawyers concerning litigation and trial practice.Michael is a member of The National Trial Lawyers Top 40 under 40, Top 10 Nursing Homes Lawyers, Top 25 Medical Malpractice Lawyers, Super Lawyers: Rising Star, and Multi-Million Dollar Advocates Forum.

Michael Hill is a founder of Eadie Hill Trial Lawyers.
Michael Hill