A stroke can run from a mild episode to one with devastating effects. It can lead to permanently reduced mental capacity and even death. Speed of treatment is the primary determinant of how severe a stroke's effects may be.
But what many patients don’t realize is that as many as 20% of strokes are misdiagnosed. Misdiagnosis can lead to a delay in proper treatment or even the provision of treatment that further harms the patient. When such a mistake is made, a patient (or a deceased patient’s family) may be able to sue a doctor for medical malpractice.
In the sections that follow, this article discusses the proper diagnostic procedure for patients with a suspected stroke, conditions that can be confused with stroke, and how to prove that a misdiagnosis amounted to medical malpractice.
A stroke is an abrupt interruption of blood flow to part of the brain. Timing is critical in stroke diagnosis because the longer the brain cells are deprived of blood flow, the more blood cells will die.
Symptoms of a stroke include:
A doctor who suspects a stroke will usually order a CT scan of the brain and possibly an MRI. Those tests should reveal whether a patient is suffering from a stroke and what type of stroke it is. A doctor may order additional tests to determine the cause of the stroke. For example, if the doctor believes that the stroke was caused by a blood clot, the doctor may order a series of blood tests to determine how to prevent future clots.
There are two basic types of stroke: ischemic (caused by a blood clot) and hemorrhagic (caused by bleeding). It is critical for a doctor not only to quickly determine whether a patient is suffering from a stroke, but also to quickly determine the type of stroke. The medication for one type can negatively affect a patient suffering from the other type.
A doctor may misdiagnose a patient with stroke-like symptoms even after imaging tests have been conducted. A misdiagnosis can come in the form of either failing to properly determine the type of stroke, or as diagnosing a stroke as some other illness. Below are a few illnesses that may be challenging to differentiate from a stroke, upon early diagnosis:
Defined as a patient with a dangerously low blood glucose level, hypoglycemia can cause symptoms similar to those associated with a stroke. However, a doctor should be able to determine whether hypoglycemia is causing the symptoms fairly quickly by testing the patient’s glucose level.
Whether cancerous or not, a brain tumor can cause symptoms that mimic a stroke. The primary difference is that tumor symptoms tend to increase gradually in severity as the tumor grows whereas stroke symptoms tend to present suddenly and acutely. But this distinction can be of little use to a doctor when a patient arrives to the hospital having lost consciousness.
Seizures and post-seizure events can cause alterations in brain functioning that mimic the symptoms of a stroke. If the doctor observes the seizure or is told of a history of seizures, the doctor may be more likely to diagnose a stroke as a seizure-related impairment of brain functionality.
The primary means of distinguishing stroke from other ailments is brain imaging tests, including CT Scan and MRI. But because the images are not always conclusive, doctors can make mistakes even after the proper tests have been performed.
In assessing most patients who present with a potential health problem, a doctor performs what’s called a differential diagnosis. This means making a list of possible medical conditions that could be behind the symptoms, conducting a series of tests, then ruling out different conditions that don’t match up to test results, until a definitive diagnosis can be determined. So, let’s take the case of a patient who presents with potential symptoms of a stroke, but the doctor fails to properly diagnose the condition, treating the patient for some other condition.
In order to hold the doctor legally liable for medical malpractice, the patient (usually through his or her attorney and a retained medical expert witness) will show how the doctor deviated from the accepted medical standard of care in conducting the differential diagnosis -- first walking the jury through what a reasonably skilled physician would have done under similar circumstances, and then showing how the doctor’s chosen course of treatment in the instant case failed to meet that standard.