On April 8, 2019, a New York medical malpractice jury in Queens County, New York announced its unanimous verdict in the amount of $5 million in favor of the plaintiff against two radiologists whom the plaintiff alleged had failed to report an abnormality on two successive MRI scans of the brain (Chiari malformation), the first in September 2013 and the second a year later in September 2014. The medical malpractice jury jury awarded $2 million in past damages, and $3 million in future damages.
Chiari malformations are structural defects in the base of the skull and cerebellum, the part of the brain that controls balance. Normally the cerebellum and parts of the brain stem sit above an opening in the skull that allows the spinal cord to pass through it (called the foramen magnum). When part of the cerebellum extends below the foramen magnum and into the upper spinal canal, it is called a Chiari malformation (CM).
Chiari malformations may develop when part of the skull is smaller than normal or misshapen, which forces the cerebellum to be pushed down into the foramen magnum and spinal canal. This causes pressure on the cerebellum and brain stem that may affect functions controlled by these areas and block the flow of cerebrospinal fluid (CSF)—the clear liquid that surrounds and cushions the brain and spinal cord. The CSF also circulates nutrients and chemicals filtered from the blood and removes waste products from the brain.
CM has several different causes. Most often it is caused by structural defects in the brain and spinal cord that occur during fetal development. This can be the result of genetic mutations or a maternal diet that lacked certain vitamins or nutrients. This is called primary or congenital Chiari malformation. It can also be caused later in life if spinal fluid is drained excessively from the lumbar or thoracic areas of the spine either due to traumatic injury, disease, or infection. This is called acquired or secondary Chiari malformation. Primary Chiari malformation is much more common than secondary Chiari malformation.
Headache is the hallmark sign of Chiari malformation, especially after sudden coughing, sneezing, or straining. Other symptoms may vary among individuals and may include: neck pain, hearing or balance problems, muscle weakness or numbness, dizziness, difficulty swallowing or speaking, vomiting, ringing or buzzing in the ears (tinnitus), curvature of the spine (scoliosis), insomnia, depression, and problems with hand coordination and fine motor skills.
In the past, it was estimated that Chiari malformation occurs in about one in every 1,000 births. However, the increased use of diagnostic imaging has shown that Chiari malformation may be much more common. Complicating this estimation is the fact that some children who are born with this condition may never develop symptoms or show symptoms only in adolescence or adulthood. Chiari malformations occur more often in women than in men and Type II malformations are more prevalent in certain groups, including people of Celtic descent. Many people with Chiari malformations have no symptoms and their malformations are discovered only during the course of diagnosis or treatment for another disorder.
In many cases, surgery is the only treatment available to ease symptoms or halt the progression of damage to the central nervous system. Surgery can improve or stabilize symptoms in most individuals. More than one surgery may be needed to treat the condition.
If you or a loved one have been harmed due to the misdiagnosis of Chiari malformation in New York or in another U.S. state, you should promptly find a New York medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your Chiari malformation medical malpractice claim for you and represent you or your loved one in a Chiari malformation medical malpractice case, if appropriate.
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