Intrazerebrale Blutung als Tumor verkannt

Abstract

Report of a 33-year-old woman who had sudden vision problems and homonymous hemianopia on the left. A cranial computed tomography (CCT) was carried out in a radiologic practice. A native homogeneous, smooth-edged hyperdense intracerebral mass of about 5.5 cm diameter on the right parietooccipital region with density values of +50 HU was found. Only a small proportion of about 2 cm diameter was more hyperdense with density values of +65 HU. Following intravenous administration of contrast medium, a patchy increase in density of about 1 cm was seen. The mass had only a thin hypodense rim. The patient was informed that she had a tumor. Three days later, magnetic resonance imaging was to be done for further evaluation. After the patient had returned home, she had headaches, nausea and vomiting in the evening. At night, she was admitted to a hospital as emergency case. With further increase of intracranial pressure, a craniotomy was done and a hemorrhage was removed. Histologically, a bleeding of a cavernous hemangioma was found. The patient appealed to the fact-finding board for medical liability questions because she had not been admitted to a hospital immediately after the CCT. Therefore, surgery was done delayed. The board found that the behavior of the radiologist was wrong. However, it cannot be proven that this medical malpractice is of importance for the existing postoperative complaints.