Neurologist Expert Opines on Causation of Cerebral Stroke

Cody Porcoro

Written by
— Updated on December 20, 2017

This case involves a man in his mid 40s who presented to the ER early in the morning. He had an acute onset of nausea and a severe headache. Additionally, he had an elevated blood pressure and was struggling to breathe. He was admitted to the hospital with a diagnosis of abdominal pain with little explanation for his symptoms. 4 hours after being admitted, he started feeling numb on his right side, but despite the appearance of this new symptom, the nurse did not investigate further or report it to a doctor. By late evening, the patient was found unresponsive. A CT scan was ordered which revealed significant swelling of the brain and neurosurgeons concluded he had a massive cerebral stroke. Although emergency procedures were performed soon after the diagnosis, he died later that day.

Question(s) For Expert Witness

  • 1. Given symptoms noted above, does the standard of care require an imaging study or a neurologic/neurosurgery consult?
  • 2. If the patient is admitted to the hospital with a GI or abdominal issue diagnosed, but with vertigo, dizziness and headache and there is a change in altered mental status, slurring of speech and worsening headache, what work up should be done?
  • 3. Have you ever reviewed a similar case? If yes, please elaborate.

Expert Witness Response E-004640

This patient had neurological symptoms and complaints. At the minimum, she needs a head CT and a detailed neurological consultation. Given the acute onset of her symptoms, a stroke is very high on the differential and she needs vascular imaging.

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