Law Offices of Ronald C. Burke


Failure to Diagnose Stroke

Strokes kill approximately 130,000 Americans each year--one out of every 20 deaths is due to a stroke. Every year about 800,000 people in the U.S.have a stroke. It is extremely important to recognize the signs of a stroke so that you can take yourself or a loved one to the emergency room of the nearest hospital immediately. Life saving treatment and/or reducing the risk of a major life long disability requires that you get medical attention right away as minutes count.

                                             WARNING SIGNS OF STROKE

According to the American Heart Association and American Stroke Association -  "F.A.S.T." is an easy way to remember the the sudden warning signs of a stroke:

                              F- face drooping;

                              A - arm weakness;

                              S - speech difficulty;

                              T- time to call 911 (even if the signs go away).

                                                     TYPES OF STROKES

Most strokes or TIA's (85-90%) are caused by a clot (blockage) in an artery that supplies blood to the brain. These are known as ischemic strokes or transient ischemic attacks. Much less common are the hemorrhagic stroke which results from bleeding due to a ruptured artery in the brain. Emergency treatment is available and most effective if delivered quickly as there is a limited window of opportunity for successful medical treatment. A delay in proper medical treatment may have tragic and needless consequences. In deciding whether to consult an attorney you should be mindful of what medical treatment has to offer and whether you received the benefit of proper medical care.

                                       DIAGNOSTIC TESTS AND PROCEDURES

Imaging studies of the brain to diagnose a stroke, the type and location in your brain include: MRI's, CT scans and brain computed tomography. Many ischemic or embolic strokes originate from the carotid arteries which run along each side of your neck. Other diagnostic studies include a carotid ultrasound which create pictures of the insides of your carotid arteries which supply oxygen rich blood to your brain. A CT arteriogram and magnetic resonance arteriogram can show the large blood vessels in the brain, the site of a clot and the flow of blood through your brain.

An EKG (electrocardiogram) can help detect heart problems that may have led to a stroke. Blood clots can travel from the heart to your brain causing a stroke. Another useful tool is echocardiography that uses sound waves to create pictures of your heart. A transesophageal echocardiogram involves placing a flexible tube down your throat into the esophagus which provides even more detail. It can also detect possible blood clots inside the heart and any problems with the aorta (the main artery carrying oxygen rich blood from your heart to all parts of your body). Lastly, blood tests to check for low blood glucose levels which may cause symptoms similar to those of a stroke. Abnormal platelet levels may be a sign of a bleeding disorder which causes too much or too little clotting.

                                              TREATMENT FOR STROKES 

To treat an ischemic stroke caused by a clot, doctors must quickly restore blood flow to your brain. There are anti-coagulation and ant-platelet therapies to consider.Therapy with clot busting drugs must start within 3 - 4.5 hours. Aspirin is an immediate treatment given in the emergency room to reduce the likelihood of having another ischemic or embolic stroke because it prevents blood clots from forming. There are drugs or transfusions of blood products to provide to patients with hemorrhagic strokes who have been on blood thinners like coumadin. You may also be given drugs to lower the pressure in your brain, other drugs to lower your blood pressure and/or drugs to prevent vasospasm or seizure

Some stroke victims may be eligible for a clot busting drug called "TPA" (tissue plasminogen activator). However, TPA must be given within 4.5 hours after the stroke symptoms started. This drug has serious risks, so if the stroke patient arrives at an emergency room 6 hours after the stroke symptoms began TPA will not be given. However, if the patient arrives in time and the doctor fails to treat a suitable stroke patient with TPA, there may be a meritorious claim of malpractice.

Prompt surgical intervention may also be life saving in the event of a stroke. Your doctor may recommend a procedure to open up an artery that has narrowed due to fatty deposits or plaque. A Carotid Endarterectomy involves the removal of plaques from the arteries that run along each side of your neck. Angioplasty involves inserting a balloon thru a catheter into a blood vessel to expand the narrowed artery. At that time a stent can be inserted to support the opened artery.

For treatment of a hemorrhagic (bleeding) stroke, surgical clipping of an artery to stop blood flow to an area of that artery which has a weakened wall. Clipping off this area of the artery can keep it from bursting or re-bleeding.  This condition is known as an aneurysm and can be best illustrated by comparison to the development of a bubble in a bicycle tire. Other surgical methods involve coiling or endovascular embolization or surgical removal of an arteriovenous malformation (AVM).

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