The guidelines for head injuries

There are clear NICE guidelines in place for how patients complaining of head injuries should receive CT scan upon arrival at A&E centres. Even where there has been very mild head injury this applies. A client of mine several years ago was not scanned after a very mild head injury and the final result was a very high-value seven-figure payout by the relevant health authority a few years later, for breach of duty when she went on to suffer a stroke.

However, how useful is the standard CT scan as opposed to the 3-dimensional MRI scan? The latter captures the brain in motion in real-time and the level of detail in this scan makes it much easier to diagnose aneurysms and other troubling occurrences going on in the brain.

The reality of the situation is that due to the very high cost of the 3D scan and due to the extreme financial pressures currently on The NHS this scan is very rarely offered in the 'bog-standard' head injury case. However, we know that very important issues can be picked up with this scan that cannot be picked upon the standard CT scan.

I have experience of 2 cases where this has come into focus.

Head injury case one

One involved a client who had been diagnosed with either a mild brain injury or concussive disorder (depending on which of the opposing neurologists on the case was to be believed). The seriousness of the head injury was a very live issue in the case 2 years on. The client had only been offered and received the standard CT scan which had not shown up much at all. We decided upon advice from our neuroradiologist expert to arrange the 3D MRI scan. It was a tactical risk as if the findings came back negative it would still have to be disclosed to the Defendant. The findings came back positive of multi microaneurysms and these were observed on the big screen together with a neurologist, neuroradiologist and our counsel at our London office.

It was a light bulb moment for me to see for myself how much better the enhanced imaging process could be in a head injury case. The case settled shortly thereafter for a seven-figure sum.

Head injury case two

The other case involved a lady in her30s in a car accident who went on to develop epilepsy. Again, the standard CT scan was arranged at A &E showing nothing of significance. The client was using blood-thinning medication. A 3D scan was arranged which showed aneurisms not picked up on the standard scan and this enabled the claim to settle when before this was available, medical causation was strongly contested and no offers were forthcoming. If a client is on blood-thinning medication such as warfarin it is more likely that the 3D scan will pick up the aneurisms.

So, conclusions to be drawn - even in mild brain injury cases, particularly where expert evidence is in dispute with the other side, and even when it is not, push were possible for the 3D brain scan. It may give more clarity and certainty to any diagnosis and potentially have a game-changing impact on the legal claim itself.

If you feel like you have experienced medical negligence, please get in contact with KLS law and get a free consultation by calling 0800 015 1470.