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  • Writer's pictureHon. James M. McGing (ret.)

Strokes and Locked in Syndrome

Strokes and “Locked-In Syndrome” (LiS).

The Cleveland Clinic says that Locked-in Syndrome (LiS) is a rare and serious neurological d

isorder that happens when a part of your brainstem is damaged, usually from a stroke. A stroke occurs when the blood supply to brain tissue is blocked by a blood clot (ischemic stroke), or when a blood vessel in the brain ruptures (hemorrhagic stroke), causing brain cells to die and leading to functional impairments. Stroke is a leading cause of death and disability both globally and in the U.S., where approximately 800,000 people experience a stroke each year. Locked-in Syndrome is caused by damage to the pons, a part of the brainstem that contains nerve fibers that relay information to other areas of the brain

As a former Judge and Lawyer, this author can tell you that Locked-in Syndrome cases are very rare, but they are gut-wrenching. Trapped in a body with complete paralysis and inability to speak except to move your eyes or eyelids while your brain functions normally can make one a prisoner trapped inside their own body. How does this medical condition become a court case? Almost always as a medical negligence case. Historically, if a patient arrived at the emergency room within three hours of experiencing ischemic stroke symptoms, doctors should administer a potent clot-busting medication known as tPA and often save critical brain tissue. Previously, if more than three hours passed, the clinical guidelines stated that the medication should not be used.

But more recent studies demonstrate that the traditional three-hour time window was too short. By combining data from multiple clinical trials, Maarten Lansberg, MD, PhD, professor of neurology and neurological sciences at Stanford, showed that treatment can benefit patients up to 4.5 hours after they experience their first symptom. Every year, more than 800,000 Americans experience a stroke due to a sudden drop in blood flow to the brain. Most strokes are ischemic, meaning they're caused by a blocked artery. For these strokes, the medication tPA (tissue plasminogen activator), can open blocked blood vessels and help restore blood flow to the brain.

Why don’t ER doctors always administer tPA? Because tPA can cause bleeding in the brain and should not be given in some situations. However, if tPA is not given in a timely manner to a patient it would have benefited, the patient may be able to argue they have “lost their chance” to recover if tPA had been timely administered.

The Illinois Supreme Court has stated that the Lost Chance Doctrine is a viable theory to argue to a jury and that the plaintiff who claims injuries for a lost chance must prove that that the alleged malpractice proximately caused an increased risk of harm, or a lost chance of recovery, to a reasonable degree of medical certainty. If you or a loved one has suffered an ischemic stroke with resulting brain injury or paralysis and were not administered tPA in a timely manner, call today and speak with former Supervising Judge James M. McGing at Miller McGing Law (773) 467-8000.

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