A 45‑year‑old woman with a history of migraines visits the e…
A 45‑year‑old woman with a history of migraines visits the emergency department with the “worst headache of her life,” neck stiffness, and vomiting. The physician orders basic labs but does not perform neuroimaging or a lumbar puncture, documenting that the symptoms are “consistent with her usual migraines.” She is discharged with anti‑migraine medication. Twelve hours later, she collapses at home from a ruptured aneurysm and suffers permanent neurological impairment. During litigation, expert testimony reveals that even if a CT head had been performed at the initial visit, the aneurysm might not have been visible, and immediate intervention might not have prevented the rupture.