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Brain haemorrhages: ongoing support

is vital according to new report


December 2013

There has been a recent study into the care and outcome of people suffering from subarachnoid haemorrhages.

To you and me, this really means a brain haemorrhage and this is not something we like to think about. Yet this problem affects 5,000 people in the UK every year and it accounts for around 13% of all strokes.  From Greek roots, the word haemorrhage literally means blood bursting forth, and this is what happens in a brain haemorrhage.

The majority of brain haemorrhages are caused when a brain aneurysm bursts open. A brain aneurysm is simply a bulge in the blood vessel caused by pressure on a weakness in the blood vessel wall. If the pressure on this bulge weakens it too much it can burst and blood can surge out, damaging brain tissue. The reduction in blood supply can starve the brain of oxygen causing further damage.

Bleeding in the brain can occur at any age but middle aged people at a higher risk of developing the problem, and it is more common in women than men. There is often no clear cause for this to happen but increased risk factors include smoking, excessive alcohol consumption, poorly controlled blood pressure and a family history of similar problems. Head injuries, or diseases associated with increased bleeding, can also be risk factors.

Symptoms of a brain haemorrhage can vary and symptoms can develop suddenly or over time.

Generally, the most common symptom is a sudden and very severe headache. Other symptoms can include feeling or being sick; weakness in an arm or leg; changes in vision, loss of co-ordination or balance and loss of consciousness.

A brain haemorrhage is a major medical emergency that requires urgent specialist treatment. This will comprise of surgery to repair the source of bleeding and medication to prevent complications.

And this is where the recent report comes in - it looked at the care and outcome of patients suffering from subarachnoid haemorrhages.

It was undertaken by NCEPOD, the National Confidential Enquiry into Patient Outcome and Death. This is a robust body that started 25 years ago to offer critical examination of what is actually happening to patients with an aim of improving patient care and safety.

Co-author of the study was Professor Michael Gough, a consultant vascular surgeon at Spire Leeds Hospital and Leeds General infirmary.

The study was based on 427 cases and there were some positive aspects; for instance 90% of hospitals are able to provide CT head scans seven days a week; and 86% of the patients studied were treated using the latest endovascular techniques.

However, problems that came out of the study included GPs failing to recognise a severe headache as a potential symptom of a subarachnoid haemorrhage, and 18% of patients not receiving a neurological examination when admitted to hospital.

Professor Gough said that the NCEPOD advisors also found a worrying under provision in rehabilitation services for patients both after surgery and following discharge. This was coupled with inadequate planning for continuing care.

“Many patients will be dependant for help with their daily living activities for the rest of their lives,” he said. “So it is vital that all patients not only receive early inpatient rehabilitation, but also rehab support that continues in the community once they have been discharged from hospital. This is essential to help them make as good recovery as possible.”

It seems clear that for anyone suffering from a brain haemorrhage, not only is it important to ensure immediate medical treatment, but it is also vital to ensure good levels of ongoing support and care.  

More general information can be found on:
http://www.bafound.org/subarachnoid-hemorrhage


 

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