LITIGATION ISSUES IN THE TREATMENT OF CEREBRAL ANEURYSMS – AN ONGOING CHALLENGE

A. Bibiriță, C. Toader, A. A. Marinescu, A. V. Ciurea

Abstract: The rupture of a brain aneurysm triggers a serious form of hemorrhagic stroke, the aneurysmal subarachnoid hemorrhage. This serious affliction that often presents as a sentinel headache is often mistaken for a migraine and quickly dismissed, with devastating consequences. Once an accurate diagnosis is made, supporting therapeutical measures are in place until the aneurysm is secured but sealing the aneurysm off is the only permanent treatment that eliminates the risk of a rebleeding, which is fatal in 90% of cases. The main clinical struggles that can be used as ground for litigation in aSAH are the misdiagnosis at presentation and failure to complete the aneurysm occlusion in a time-efficient manner. This article is based on the following hypotheses: 1. What represents a serious ground for litigation in case of a patient with aSAH? and 2. What constitutes a litigation issue for the physician in case of a ruptured aneurysm that hasn’t been secured (either by surgical clipping or endovascular coiling)?
Keywords: aneurysmal SAH, sentinel headache, misdiagnosis, litigation in aSAH