When is vertigo or dizziness a sign of a medical emergency?

 

Vertigo can be an early sign of a life-threatening cerebrovascular problem

 
May 8, 2018

One of the challenges in medicine is that there are many symptoms that a person might have that are consistent with a different medical condition.  Some of these conditions may be relatively harmless, but others may be deadly.

Vertigo is one of those conditions.  When experiencing vertigo, you feel like your surroundings are spinning or the inside of your head is spinning.

One of those common types of vertigo is paroxysmal positional vertigo.  This form type of vertigo is usually triggered by changing the position of your head and often has a duration of a minute or less.  Some people experience positional vertigo when they sit up or move their head up or down.

Medical experts recommend seeing a doctor if you experience on and off or occasional vertigo or dizziness for a period of over one week.

On the other hand, you should go to the emergency room if your vertigo or dizziness is accompanied by a headache that is new, different, or severe (some people describe it as the worst headache of their lives); fever; vision problems, including vision loss or double vision; hearing loss; altered speech or speaking; weakness in the extremities; loss of consciousness, difficulty walking, and numbness or tingling.

Emergency room doctors, nurses, nurse practitioners, and physician assistants frequently see people with vertigo in the emergency room, so they often have the temptation of skipping diagnostic steps and concluding that it is harmless and will go away on its own.  Medical malpractice cases that I have recently handled show why this practice is dangerous to patient safety.

As a Houston, Texas medical malpractice attorney, I have recently reviewed several cases where patients had one of these non-specific symptoms, vertigo. 

In one case, a woman working in the McAllen, Texas area started experiencing bad headaches, along with nausea, vomiting, and vertigo.  She first went to an urgent care clinic, then a family practice doctor, and finally a neurologist.  In reviewing the neurologist’s office chart, I was surprised to see that the only complaint or symptoms that he documented was vertigo.

The neurologist ordered an MRI, which came back normal, so he concluded that she had harmless vertigo and discharged the patient from his care.  In less than a year, she experienced a massive aneurysm. Both the neuroradiologist and neurologist experts that Painter Law Firm hired to review this unfortunate lady’s potential case felt that advanced imaging, like an MRA or CT angiogram, would have shown the aneurysm at the time the MRI scan was performed.

The question, then, was whether there was an indication for the neurologist to order such advanced imaging. After recovering from the aneurysm, the patient was left with little memory of what went on in her treatment.  For example, she does not know whether she shared her full list of symptoms with the neurologist, or, if on that day, she only talked about the vertigo.

What is clear, though, is that it is important to provide your emergency provider or physician with a detailed account of any of your symptoms that accompany vertigo.  This should help the doctor realize that you may not have a case of “plain vanilla” vertigo and require an urgent workup. 

In another case that I am working on, involving a hospital in The Woodlands, Texas, a middle-aged man went to the hospital emergency room two days in a row with complaints of vertigo, nausea, vomiting, and difficulty walking.  On both dates, the emergency providers botched the diagnosis, skipped important diagnostic steps, and concluded that he was experiencing a harmless vertigo.  They also ignored the fact that he had experienced a bad fall within a week of his first emergency room visit.  Ultimately, they discovered that he had dissected (injured) a key artery on his fall and ended up having a stroke.

We are here to help

If you or someone you love has been seriously injured by the misdiagnosis or improper medical workup of vertigo, our experienced medical negligence attorneys can help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.

All consultations are free and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case.

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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. In 2017, H Texas magazine named him one of Houston’s top lawyers. Also in 2017, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.

Robert Painter

Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.

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