Court Matters

Many of us will experience low back pain at some point in our lives however it is not usually something that requires surgery. Cauda Equina Syndrome is a rare condition whereby something compresses the nerves at the base of the spine.

The nerves at the base of the spine are shaped liked a horses tail and the syndrome gets its name from the Latin for horses tail which is “Cauda Equina.”

The condition is a medical emergency and therefore it is important that doctors can recognise the symptoms of the condition to ensure that treatment can be provided as soon as possible, to avoid any long term effects of the syndrome. The condition can be hard to diagnose as the symptoms are similar to a wide range of other conditions however if you have any of the following symptoms you should seek urgent medical advice or attend your nearest Accident and Emergency Department:

• Severe low back pain
• Pain, numbness, or weakness in one or both legs
• Loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet that is severe or gets worse and worse
• Incontinence / Problems with bowel functioning
• Sexual Dysfunction

In diagnosing Cauda Equina Syndrome your doctor will consider your medical history, symptoms, general health and you may need to have the following investigations carried out to confirm the diagnosis:

• A physical examination to assess your strength, reflexes, sensation, stability, alignment, and movements
• Blood Tests
• MRI scan of your spine
• A myelogram. Which is an X-ray using special dye to try to pinpoint pressure on the spinal cord or nerves
• CT scan

If you have Cauda Equina syndrome you will require emergency spinal decompression surgery to relieve the pressure on the nerves. Surgery should take place within 48 hours of the initial onset of symptoms in order to ensure the best possible outcome. If surgery is not performed within 48 hours there is a risk of permanent damage, such as paralysis of the legs, loss of bladder and bowel control, sexual function, or other problems.

If you have ever been diagnosed with Cauda Equina Syndrome and you are concerned about the treatment/ lack of treatment received or perhaps you have permanent damage, you may be entitled to claim compensation.

A subdural haematoma can develop after a bump to the head for example as a result of a fall, a violent assault, car accident or occasionally after a minor bump to the head.

A subdural haematoma is a serious condition whereby blood collects between the skull and the surface of the brain known as the subdural space. Pressure builds up in the subdural space as the blood forms into a clot (haematoma) and can cause brain damage.

There are two different kinds of subdural haematoma an acute haematoma and a subacute or chronic subdural haematoma. An acute haematoma develops soon after a severe head injury and a chronic haematoma can take a few days or weeks to develop and are more common with minor head injuries.

The symptoms of a subdural haematoma can include:

• a headache that keeps getting worse
• feeling and being sick
• confusion
• personality changes, such as being unusually aggressive or having rapid mood swings
• feeling drowsy
• loss of consciousness

You should always attend your nearest Accident and Emergency Department following a head injury as precaution. If the symptoms develop a few days or weeks after a bump to the head you should still go to your nearest Accident and Emergency Department to get yourself checked out.

When you arrive at hospital the doctor will be asked questions with regard to your medical history and any physical injuries such as cuts and swelling as well as checking your pupils for any signs of brain injury will be examined. You will also be assessed on your verbal, motor and eye response in accordance with the Glasgow Coma Scale (GCS). You will be given a score between 3 and 15, 3 being the worst and 15 being the best. A CT Scan may be carried out to show whether any blood has collected and in some cases an MRI Scan will be carried out to help diagnose a haematoma.

If you are diagnosed with a subdural haematoma you may require surgery in order to relieve the pressure on the brain.