On March 20, 2026, a Virginia medical malpractice case was settled during the first week of trial after the defendant’s expert testified. The case had been tried twice before: the first trial ended in a verdict for the plaintiff that was reversed on appeal, and the second trial resulted in a hung jury.
Background Facts
The plaintiff experienced a severe headache that led to a head CT scan being performed. The CT scan reportedly revealed a small subarachnoid hemorrhage in the convexities of the right occipital lobe. The plaintiff followed up with the defendant physician, who ordered a cerebral angiogram to investigate the cause of the subarachnoid hemorrhage. As a result of the cerebral angiogram, the defendant physician diagnosed the plaintiff with a 2-millimeter to 3-millimeter aneurysm located in the left middle cerebral artery that the defendant incorrectly concluded had previously ruptured, which the defendant concluded was the cause of the subarachnoid hemorrhage. The defendant surgeon recommended that the aneurysm be surgically treated. During the surgery, the aneurysm ruptured and caused the plaintiff to suffer a debilitating stroke.
The plaintiff alleged in her Virginia medical malpractice lawsuit that the aneurysm was an incidental finding, that the aneurysm had not previously ruptured, and that surgery was unnecessary. Her expert opined that the plaintiff’s subarachnoid hemorrhage was due to a condition known as reversible cerebral vasoconstriction syndrome (RCVS), which is a self-limited and does not require surgery.
Reversible Cerebral Vasoconstriction Syndrome (RCVS)
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden explosive and severe headaches that occur over days to weeks due to underlying widespread cerebral vasoconstriction. These headaches reach peak intensity within the first minute and are often described as “thunderclap” headaches. Although typically benign and self-limited, RCVS can lead to severe complications such as ischemic stroke, convexity subarachnoid or other intracerebral hemorrhage, and posterior reversible encephalopathy syndrome (PRES).
Current treatment approaches to RCVS are predicated on recognizing it as a predominantly benign and self-limited condition. The goal is to avoid misdiagnosis that could lead to unnecessarily invasive investigations, favoring symptomatic treatment over empiric approaches. If triggers are identified, it is crucial to remove them whenever possible until clinical symptoms and imaging findings are resolved.
Significant complications primarily occur within the first week after headache onset in RCVS. These include localized convexity (non-aneurysmal) subarachnoid hemorrhage (22%), leukoencephalopathy (9%), intracerebral hemorrhage (6%), seizure (3%), and transient ischemic attack or ischemic stroke (20%), with the majority of ischemic events occurring in the second week. These complications can potentially result in permanent residual neurological deficits.
If you or a loved one suffered harm as a result of medical misdiagnosis in Virginia or in another U.S. state, you should promptly find a Virginia medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
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