Neurological Malpractice

Neurological malpractice can come in a number of forms.  To understand these types of claims it is necessary to have the basic understanding of the brain and the spinal cord.  The brain and spinal cord are protected by membranes that are called meninges.  Within those meninges and surrounding the brain and spinal cord is cerebral spinal fluid which cushions the brain and spinal cord.  This brain fluid flows from a series of receptacles that are called the ventricular system.
The brain and spinal cord are further protected by a blood-brain barrier which is a series of small, tightly sealed capillaries that prohibit the movement of potentially toxic substances into the brain. 

Evaluating Neurological Malpractice Cases

In evaluating neurological malpractice cases it is important to do the following:

  • identify the nature of the injury or disease
  • identify the pathology that caused the injury or disease
  • be certain that the injury was foreseeable and avoidable
  • be prepared to logically rule out any other causes
  • what is the likelihood the patient has an aneurysm
  • what is the likelihood the patient is having a stroke or what some call a mini-stroke

Medical malpractice in the diagnosis of brain aneurysms can have catastrophic consequences. Aneurysms are ballooned areas on arteries. If the rupture of the artery is in in the brain then the arterial pressure can force the blood into the subarachnoid space,which is the area right above the membrane closest to the brain. This blood then quickly seeps into the cerebrosponal fluid which encapsulates the brain and the spinal cord.This brain bleed results in a sudden and explosive headache. Sometimes this explosive headache is preceded by a warning headache.

Neuroligical Malpractice: Brain Aneurysm Misdiagnosis

The most common symptoms and findings are:

  • severe headache reported as being the worst headache of my life
  • neck pain
  • drowsiness
  • restlessness
  • nausea
  • vomiting
  • neurological weakness or paralaysis
  • visual problems
  • abnormal eye movements
  • sensitivity to light
  • retinal bleeding evident upon eye exam
  • EKG reading reporting a myocardial infarction

In some cases none of the above signs and symptoms are present other than the severe, sudden headache.

A proper workup of a patient with a suspected brain aneurysm is a CT without contrast. If that is negative then a lumbar puncture may be in order to check for the presence of blood in the cerebrospinal fluid.

With a thorough history,physical exam and diagnostic workup patients with a subarachnoid hemorrhage should be properly diagnosed.

Neurological Malpractice: Epidural Abscess

Epidural abscess misdiagnosis can be be fatal. This infection is most often associated with severe back pain and a fever. The abscess itself is a bacterial infection outside the dura mater within the spinal canal. The abscess itself is frequently slow growing and it causes damage by compressing the spinal cord or restricting circulation in the surrounding blood vessels. If it is not treated, it can progress to the point of causing spinal cord damage, paralysis and death.

Neurological Malpractice:Epidural Abscess Antibiotic Treatment

Once the condition is treated then antibiotic therapy must be started at once, and in most cases surgery must be performed to drain the abscess.

If the treating or admitting physician suspects an epidural abscess the standard of care requires a prompt referral to an infectious disease doctor, neurologist or a neurosurgeon for diagnosis and treatment. MRI is still the standard for prompt confirmation of the condition as this allows a reasonably clear picture of any cord compression and the severity of the compression.

See also bone tumor misdiagnosis and several other articles on this site dealing with medical malpractice

Contact a Neurological Malpractice Attorney

If you have been injured as a result of neurological malpractice, contact us.