All surgeries carry a risk, but patients and their families suffer when medical professionals make surgical errors or fail to recognize a patient’s risk factors for a stroke before or after surgery. When unexpected deaths, additional surgeries, extended hospital stays, or life-changing disabilities could have been prevented if not for the negligence of medical staff, Indiana patients and their families can seek compensation with the help of a medical malpractice lawyer.
Surgical Mistakes Happen and So Do Strokes
Doctors and medical professionals take the Hippocratic oath promising to do no harm. When a patient is told surgery is necessary, the doctor should advise the patient of all risks that are involved and possible complications associated with the surgery. This includes whether there is any possibility of a stroke because of the surgery. Surgical injuries such as strokes can happen because of surgical errors and can fall under medical malpractice.
What is a Stroke?
A stroke is a medical condition where the blood flow to an area of the brain is cut off. When this happens, the cells in the brain are deprived of the oxygen and glucose they need to survive. Without this nourishment, the brain cells die. Almost half of all strokes can be prevented. Permanent brain damage or death can occur when a stroke is not caught early. There are two types of stroke.
Almost 80 percent of all strokes are ischemic. An ischemic stroke is like a heart attack, but it happens to the brain instead. A clot forms in the blood vessels of the brain or is formed elsewhere in the body and then travels to the brain. The clot then blocks blood flow to the brain. This is the most common type of perioperative strokes that are life-threatening and disabling. These strokes can occur from any time beginning from the time the patient is admitted to the hospital for surgery until he or she is discharged from the hospital.
A hemorrhagic stroke occurs when a blood vessel within the brain ruptures or breaks. When this happens, the blood seeps into the brain tissue and damages the brain cells. Hemorrhagic strokes are caused usually caused by high blood pressure or a brain aneurysm, which is thinness or weakness in the wall of a blood vessel.
Risk Factors for Perioperative Strokes
Some patients are at a higher risk for a perioperative stroke than others. Older people, smokers, and females are at increased risk. Other risk factors include having:
- High cholesterol
- High blood pressure
- Peripheral vascular disease
- Chronic obstructive pulmonary disease
The type of surgery performed also increases the risk for a stroke. With most surgeries, the risk is less than 1 percent for a perioperative stroke. The risk rises to 5 percent for surgeries involving head and neck tumors. Heart surgeries carry the highest risk with up to a 10 percent risk of a perioperative stroke.
How Perioperative Strokes are Treated
A physician could choose to act proactively to reduce the risk of a perioperative stroke by placing the patient on blood thinning medications. But even these medications come with a risk of increased bleeding. The physician must weigh the risk of stroke against the risk of complications from increased bleeding. Studies have also shown that with many surgeries, including cardiovascular surgeries, giving patients aspirin, which is a blood thinner could outweigh bleeding risks.
Medical personnel needs to continually monitor surgery patients, especially those in a high-risk group for post-operative complications, including perioperative strokes. If a stroke does happen, they need to move quickly to minimize its effects and prevent permanent brain injury. However, physicians are also faced with the risks that different treatments present.
- Intravenous clot-busting drug (rtPA) is known for its ability to quickly break up clots and help reverse the effects from a stroke. However, this injection cannot be used on patients who have recently had surgery because of the increased risk of surgery. Instead, this drug may be delivered via a catheter directly to the clot.
- Mechanical clot-busting and ultrasound treatments are used to treat clot-based strokes. But their effectiveness has not been tested in instances of perioperative strokes.
- In large strokes where life-threatening brain swelling occurs, a hemicraniectomy may be needed to save the patient’s life. In this surgery, the surgeon must temporarily remove part of the patient’s skull to give the brain more room. A hemicraniectomy is a drastic procedure, but it brings the benefit of improving the likelihood of survival and function for the patient.