Neurology Expert Discusses Relationship Between Stroke and Previous Injury

This case involves a middle-aged woman who suffered a neck injury while participating in a three-legged race at an event sponsored by her church. Just over a month after the injury occurred – which, at the time, did not manifest many physical symptoms beyond bruising and soreness – the woman presented to the emergency room complaining of excruciating, tearing pain in her chest as well as right-sided weakness. It was discovered that the woman had suffered from a significant aortic dissection, as well as a stroke and descending aortic aneurysm, and required significant effort and expense to treat. Lacking other cause, the Plaintiff claimed that the injury she suffered during the three-legged race at her church some weeks prior was the direct and proximate cause of her subsequent stroke and dissection.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case?

2. Is it likely that a stroke can occur following aortic dissection of the carotid artery?

Expert Witness Response E-006727

I do frequently evaluate patients with stroke from a variety of sources who are admitted to or evaluated in the ER of an acute care hospital. MCA stroke can certainly occur after aortic dissection. However, given the little detail that is given here it seems likely that the history of hypertension and diabetes were the cause of aortic disease. Traumatic dissections can occur due to fairly minor trauma including head or neck trauma but this is usually in the vertebral arteries, not the aorta. An aortic dissection, in my experience, is not likely to be caused by trivial trauma. In addition, a delay of 38 days without intervening symptoms would be highly unusual.

Expert Bio

This highly qualified expert is board certified in neurology and has been practicing for 16+ years. He received his PhD degree from the University of Pennsylvania and completed his internship training at Graduate Hospital before concluding both his residency and fellowship trainings at the University of California, San Francisco. He is a fellow of the American Neurological Association and a member of various other professional associations, including the American Academy of Neurology and the Society for Neuroscience. He has published 70+ peer-reviewed journal articles, serves in the editorial board of 6+ renowned medical journals, and has received multiple honors for his work as an academic and practitioner. He lectures both nationally and internationally and is a former Assistant Professor at UCSF. Currently, he is the endowed chair of neurology and a Professor of neurology at a top 10 university in California.