Missed Diagnosis of Subdural Hematoma Results in Brain Damage

ByMichael Talve, CEO

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Updated onJanuary 24, 2022

Missed Diagnosis of Subdural Hematoma Results in Brain Damage

This case involves a sixty-two-year-old male who was involved in a motor vehicle accident and sustained severe whiplash associated with a brief loss of consciousness. Three days after the accident, the patient presented to his primary care physician complaining of headaches and mild nausea. The physician’s initial impression was that the patient suffered a concussion and a mild neck strain. The plan was to have the patient take Tylenol and return in three weeks if no improvement was seen. Approximately six weeks later, the patient began to display signs and symptoms consistent with a subdural hematoma. A CT scan showed a six-millimeter, mid-line shift and mass effect on the ipsilateral ventricles. The patient underwent an immediate craniotomy for decompression but continues to have residual left side motor and sensory deficits.

Question(s) For Expert Witness

1. During the initial visit, should the emergency room have consulted a neurosurgeon before discharging this patient?

Expert Witness Response E-000572

inline imageWhen a patient who experienced head trauma presents with a Glasgow Coma Score (GCS) less than twelve, consider immediate neurosurgical consultation while stabilizing the patient and diagnostic maneuvers are in progress. Small, asymptomatic, acute subdural hematomas (SDHs), however, may be managed by observation, serial examinations, and serial computed tomography (CT) scanning. Operative intervention is required for patients with focal findings, neurologic worsening, hematoma greater than one centimeter thick, midline displacement or shift greater than five milimeters, or increased intracranial or posterior fossa pressure.

About the author

Michael Talve, CEO

Michael Talve, CEO

Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.

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