This case involves a patient who presented to the hospital with complaints of dizziness, numbness to the fingertips and face, and shortness of breath. A CT without contrast revealed a large, non-specific, oval-shaped mass centered in the region of the left petrous bone, with associated bone erosion. Radiological reports stated that the lesion was suspicious for chondrosarcoma. A further angiography imaging demonstrated a non-enhancing hyperdense extra-axial mass with the left middle cranial fossa. During the procedure, venography was performed in an attempt to diagnose the venous drainage of the lesion but this step was met with some difficulty in passing the dye contrast. The pressure of the dye injection device was increased to facilitate adequate flow. The images showed severe extravasation of dye contrast into the surrounding brain parenchyma and the physical exam of the patient showed blown pupils.
Question(s) For Expert Witness
- 1. Was this procedure within the standard of care?
Expert Witness Response E-004038
Close examination of the previous radiology scans would reveal if the aneurysm was clearly visible and determine if this procedure should have been conducted. If it was visible, then there may be a breach in the standard of care because of the high probability for the AVM to bleed and cause serious neurological damage.