A patient with the symptoms of cauda equina syndrome must undergo immediate investigations to confirm or exclude a diagnosis. Of utmost importance is an emergency MRI scan.
Investigations for cauda equina syndrome
Cauda equina syndrome is a medical emergency. Therefore a patient displaying the signs of cauda equina syndrome must be investigated without delay. The symptoms that warrant immediate investigation include:
- Numbness in the perineum, buttocks, legs and feet
- Urinary dysfunction
- Back pain
- Progressive weakness in the legs
First of all medical practitioners may want to conduct a neurological examination. This will verify the presence/absence of:
- Reduced sensation
- Reduced anal tone
- Poor reflexes
- Positive straight leg raise
If this examination tallies with a diagnosis of cauda equina syndrome, the patient should be referred to hospital (if not already there) and the neurosurgical team consulted.
MRI scan for cauda equina syndrome
The neurosurgical team should recommend emergency MRI scan followed by emergency surgery. If there is no facility for an emergency MRI scan at the hospital, the patient should be referred to another hospital where this can be carried out.
Emergency MRI scanning is absolutely vital, particularly if the patient still has incomplete cauda equina syndrome (meaning there is still some bladder control.) An emergency MRI scan means it should be performed on the same day as admission, or the following morning if the patient is admitted very late at night.
If the MRI scan confirms a diagnosis of cauda equina syndrome, decompression should be arranged, again on an emergency basis.
Significant delay in treatment
A patient who presents with incomplete cauda equina syndrome must undergo emergency MRI scanning and emergency surgery. This should be done on the same day the patient presents to hospital.
If there are any delays in this medical care, there consequences will be troubling. A delay of more than 48 hours between the onset of neurological symptoms from acute CES and surgical decompression is especially worrying. Indeed, medical practitioners believe 48 hours is the amount of time it takes for the nerves to be irreversibly damaged. If treatment is delayed for more than 48 hours, long-term damage will occur.
A patient who suffers harm because of significant delays in cauda equina care could be entitled to pursue a claim against the hospital. This is because emergency surgery would have resulted in improved bowel and bladder function, improved perineal sensory disturbance and improvement in motor power in the limbs.
Contact us today
If you have been left with long-term neurological injuries because doctors did not investigate your cauda equina syndrome with the urgency required, please get in touch with us today. You could be entitled to compensation.