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Stroke

The Ontario Stroke Network, which publishes national stroke data, indicates that stroke is the leading cause of adult disability in Canada and the third leading cause of death. Every year, there are over 50,000 new strokes in Canada. Over 400,000 Canadians are living with the effects of a stroke.

It is no surprise that one of the most frequent issues that we are consulted on is the issue of possible medical malpractice for stroke cases.

Preventing Stroke

When we are investigating a potential stroke malpractice claim, one of the first things that we look at is whether there was any element of malpractice in relation to the fact that the stroke occurred. As discussed earlier, in relation to obstetrical, neonatal, and paediatric claims, fetal strokes can occur during the course of labour and delivery as a result of oxygen deprivation — medically referred to as hypoxia ischemia.

Most strokes, however, occur in adults. There are two basic types of stroke:

1. Ischemic Stroke: where a clot blocks the blood flow in a blood vessel to or in the brain, which results in the death of brain cells for that blood vessel’s distribution
2. Hemorrhagic Stroke: where there is a burst blood vessel

In both situations, the blood flow to the brain cells and parts of the brain is disrupted, resulting in the brain cells not receiving the necessary oxygen, glucose, and other nutrients required for the cells to survive.

The medical malpractice analysis in any given case requires knowledge of whether the stroke was ischemic (due to a clot) or hemorrhagic (due to a bleed). The failure to properly treat longstanding high blood pressure or an unexpected rapid increase in blood pressure can result in damage to the blood vessels in the brain and an increase in the risk of hemorrhagic stroke. By the same token, the failure to properly treat blood clots can result in a stroke for those adults with a patent foramen ovale (the passage between the two chambers of the heart that closes, for most people, at the time of delivery).

It is also important to distinguish between a stroke and a transient ischemic attack (TIA) — sometimes referred to as a mini-stroke. A TIA occurs when the blood flow to a part of the brain is stopped for a short period of time. This can result in symptoms similar to a stroke but, unlike a stroke, a TIA does not cause brain cells to die. However, approximately 40% of people who have suffered a TIA will go on to have a stroke. It is, therefore, important for anyone who has experienced a TIA to receive prompt treatment, which may include medication to control blood pressure, aspirin, lifestyle changes, or surgery for clogged arteries in the neck. Prompt treatment of a TIA reduces the risk of stroke.