Jury Clears Neurosurgeons In Cerebellar Stroke Case

A 45 year-old school nurse presented to the ER with complaints of severe headache, syncope and photophobia. CT scan showed a hyperdensity which was suspicious for hemorrhage. MRI did not show an active bleed, and a CT angiogram performed on day 4 of the admission revealed two dissecting pseudoaneurysms in the distal posterior inferior cerebellar artery (PICA). Plaintiff's expert contended that the defendant neurosurgeons were negligent in failing to perform a lumbar puncture, failing to rule out a subarachnoid hemorrhage, and discharging the patient for outpatient follow-up which was to include a cerebral angiogram in a week. Plaintiff contended that the headache was the "worst of her life", which defendants disputed. Two days after being discharged from the hospital, the plaintiff presented at a different hospital where a lumbar puncture revealed xanthochromia, and CT revealed a stable collection of blood which was unchanged from the CT six days earlier. A non-party neuroradiology interventionist performed a glue embolization on day two of the admission, noting that the defendants had "missed SAH" and the dissecting aneurysms were "ruptured." The plaintiff suffered a cerebellar infarct following the glue embolization. Defendants contended that the stroke was the expected consequence of a glue embolization procedure. Plaintiff's expert contended that the stroke was made worse by vasospasm, which was a consequence of the alleged delay in treatment. The defense was supported by the testimony of a board certified neurovascular surgeon and board certified neuroradiologist. The evidence on the defense case included an animation of the glue embolization procedure. The jury returned a unanimous verdict in favor of the defendants after deliberating for two hours.