Coroner's Finding: de-identified OQ

41y · Female·frontal lobe ischaemic infarcts (strokes) caused by cerebral artery vasospasm complicating subarachnoid haemorrhage due to ruptured saccular aneurysm

A 41-year-old woman died from frontal lobe ischaemic infarcts caused by cerebral vasospasm complicating subarachnoid haemorrhage from a ruptured aneurysm. She presented to multiple healthcare providers over five days with headache, neck stiffness, photosensitivity, vertigo, nausea, vomiting, and a syncopal episode. Critical failures occurred at the Royal Hobart Hospital ED on 18 July when staff rapidly accepted a migraine diagnosis without sufficiently considering subarachnoid haemorrhage or reviewing available ambulance notes from 15 July that documented concerning symptoms. A CT scan at this presentation would have revealed the haemorrhage. Earlier diagnosis and aneurysm securing via coiling or clipping may have prevented subsequent vasospasm complications and death. The coroner emphasised the importance of actively investigating life-threatening intracranial conditions in patients with relevant symptomatology.