It started with a blow to the head.
A car crash. A fall. A hit while playing sports. A slip on the ice. Maybe you lost consciousness for a moment, or maybe you did not. At first, you may have seemed fine. You talked. You walked. You answered questions. But then, over minutes or hours, something changed. A worsening headache. Confusion. Drowsiness. Vomiting. Slurred speech. Weakness on one side. Maybe you, or your loved one, slipped toward unconsciousness. Blood was building up inside the skull, pressing on the brain.
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Article written by Brendan Lupetin, Esq. Brendan is a managing partner in the law firm of Lupetin & Unatin, a medical malpractice law firm located in Pittsburgh and serving Western Pennsylvania.
Our practice is limited to high-value catastrophic cases because that is where we can do the most for our clients and for patient safety.
So you got help. You went to the ER, or maybe you were already there. And maybe they did not take the head injury seriously enough. Maybe they focused on other injuries. Maybe they never did a CT scan of the head. Maybe a scan was done but the bleed was missed or underestimated. Maybe you were sent home with a “mild concussion” and told to rest, even though you had warning signs. The whole time, a hematoma was expanding and squeezing the brain.
By the time someone recognized it, the damage may have been done. A subdural or epidural hematoma can cause permanent brain damage or death if the pressure is not relieved fast. This is the danger doctors call “talk and die,” where a person seems fine at first and then crashes. Maybe you survived but are forever changed. Maybe you are reading this because someone you love was sent home and did not survive. And you cannot stop asking: why didn’t they catch this in time?
That question matters. A bleed inside the skull is a true emergency, and the window to act can be short. When it is missed or treated too slowly, the harm is often catastrophic and often preventable. This article explains the warning signs that a subdural or epidural hematoma was missed. It explains the serious harm a delay can cause. And it explains what you can do next. If any of this sounds like your story, Lupetin & Unatin is here to help.
What a Subdural or Epidural Hematoma Is, in Plain Terms
Your brain sits inside the hard shell of your skull, wrapped in protective layers. A hematoma is a pocket of blood. When bleeding happens between the skull and the brain after a head injury, the blood has nowhere to go, so it presses on the brain.
There are two main types. An epidural hematoma is bleeding between the skull and the tough outer covering of the brain, often from a torn artery, and it can grow fast. A subdural hematoma is bleeding beneath that covering, often from torn veins, and it can grow quickly or slowly. As the Cleveland Clinic explains, an epidural hematoma is a life-threatening emergency that can cause permanent brain damage or death, and it needs urgent diagnosis and treatment. Treatment often means emergency surgery to remove the blood and relieve the pressure.
The key word is time. As the blood builds, pressure inside the skull rises and crushes the brain. A classic and dangerous pattern is the “lucid interval,” where a person seems fine for minutes to hours after the injury, then rapidly worsens. That is why anyone with a significant head injury and warning signs needs prompt imaging and close watching. A delay can be fatal.
Why a Subdural or Epidural Hematoma Gets Missed
A bleed inside the skull can be missed for a few reasons. The injured person may look fine at first, during the lucid interval, which can falsely reassure everyone. The patient may have other dramatic injuries that pull attention away from the head. The patient may be intoxicated or confused, so warning signs get blamed on alcohol or drugs. And sometimes the wrong choice is made about whether to scan the head at all.
But doctors are trained to take head injuries seriously and to use clear rules about who needs a CT scan. Warning signs like a worsening headache, repeated vomiting, confusion, drowsiness, or weakness should trigger urgent imaging and close monitoring. A patient who seems fine but has these risk factors or signs should not simply be sent home. When a provider fails to scan, or misses a bleed on the scan, or discharges a patient who needed watching, a deadly hematoma can be missed.
Here are the common reasons a subdural or epidural hematoma gets missed:
- The patient looked fine during the lucid interval, so the danger was underestimated.
- Warning signs like worsening headache and vomiting were not acted on.
- No CT scan of the head was done when one was needed.
- A bleed was visible on the scan but was missed or underestimated.
- Confusion or drowsiness was blamed on alcohol or drugs.
- The patient was sent home with a “concussion” instead of being watched or scanned.
The Warning Signs Doctors Are Supposed to Recognize
These are the warning signs of a brain bleed after a head injury. They are the same signs a careful provider should act on fast. Especially in an older person, or someone on blood thinners, the threshold to scan should be low.
- A worsening or severe headache. Pain that keeps getting worse after the injury.
- Repeated vomiting. A warning sign of rising pressure in the skull.
- Confusion or trouble staying awake. Drowsiness, hard to rouse, or acting strangely.
- Slurred speech or weakness. Especially weakness on one side of the body.
- Unequal pupils. One pupil larger than the other is a danger sign.
- A seizure after a head injury.
- A brief “fine” period followed by getting worse. The lucid interval, a classic danger sign.
When these signs are present after a head injury, a careful provider should order a CT scan and watch the patient closely. When these signs were brushed off, the diagnosis may have been missed.
Signs Your Subdural or Epidural Hematoma Was Missed
Below are the red flags. If you recognize several of these, it may be worth a closer look at the care that was given.
You Seemed Fine, Then Got Much Worse
The “talk and die” pattern, where a person seems okay after a head injury and then rapidly declines, is a known danger. If you or your loved one had a lucid period and then crashed, and the warning was not heeded, that is a major red flag.
Warning Signs Were Not Acted On
A worsening headache, repeated vomiting, confusion, or drowsiness after a head injury are serious signs. If these were present and no urgent imaging or monitoring followed, the diagnosis may have been missed.
No CT Scan of the Head Was Done
A CT scan is the test that finds a bleed inside the skull. When a head injury comes with warning signs or risk factors, a scan should be done. If none was done and you were sent home, a bleed could have gone undetected.
The Bleed Was on the Scan but No One Saw It
Sometimes a scan is done, but the bleed is there and gets missed or underestimated by the radiologist or treating doctor. If your scan was later found to show a hematoma that was not acted on, the original reading should be reviewed.
Confusion Was Blamed on Alcohol or Drugs
Confusion and drowsiness from a brain bleed can be wrongly blamed on intoxication. If your warning signs were waved off as being drunk or high, a serious injury may have been missed.
You Were Sent Home With “Just a Concussion”
A bleed can be mistaken for a simple concussion. If you were sent home to rest despite warning signs, and it turned out to be a hematoma, the question is whether a careful doctor should have scanned or watched you.
You Suffered Lasting Harm
Sometimes the clearest sign that something went wrong is the outcome itself. People treated before the pressure builds often recover well. When treatment comes too late, the damage can be permanent. The next section covers the serious harm a delay can cause.
The Serious Harm a Subdural or Epidural Hematoma Delay Can Cause
When the blood is not removed in time, the rising pressure crushes the brain. The longer the delay, the more harm it does. Here are the serious injuries and outcomes a missed or delayed diagnosis can cause.
Death. This is the gravest risk. A bleed inside the skull can be fatal, especially when treatment is delayed. The “talk and die” pattern is exactly this tragedy. If you lost a loved one this way, your family may have a wrongful death claim.
Permanent brain damage. Pressure and lack of blood flow can permanently injure the brain, affecting memory, thinking, and function.
Paralysis and weakness. Brain injury can leave one side of the body weak or paralyzed.
Loss of speech and language. Survivors may struggle to speak or understand words.
Seizures. A brain injury can cause a lasting seizure disorder.
Coma. As pressure rises, a person can lose consciousness and slip into a coma.
Personality and cognitive changes. Many survivors have lasting changes in memory, focus, mood, and personality.
Lasting disability and lifelong care. Severe bleeds can leave a person unable to return to work or live independently.
Emotional trauma. Living through a loved one’s brain injury, or losing them, leaves deep wounds. Many families struggle with anxiety, depression, and grief for years.
Many of these outcomes share one thing in common. They often trace back to time that was lost. Time that doctors had to act, and did not use.
When a Missed Diagnosis Becomes Malpractice
Not every bad outcome is malpractice. Doctors do not have to be perfect, and some bleeds are hard to detect early. But doctors do have to meet a basic standard. That standard is the level of care a careful doctor would have given in the same situation.
To have a malpractice case, a few things usually need to be true. First, there was a doctor-patient relationship. Second, the care fell below the accepted standard. Third, that failure caused real harm. Fourth, the harm led to losses, such as medical bills, lost income, the loss of a loved one, or pain and suffering.
Brain hematoma cases often turn on a few key questions. Did the patient have a head injury with warning signs or risk factors? Was a CT scan done when it should have been? Was a visible bleed missed on the scan? Was the patient watched closely or sent home too soon? When the signs were there and no one acted, that delay can be the heart of a strong case. You can read more about how a missed brain bleed can become malpractice on our thunderclap headaches and brain aneurysms page. Proving it takes work, records, and the right medical experts. That is where Lupetin & Unatin comes in.
What You Should Do Now
If you think your subdural or epidural hematoma, or that of a loved one, was missed, take these steps.
Get the medical records, including all imaging. You have a right to them. The CT images, the radiology reports, and the timeline are often the heart of the case.
Ask for the actual scans, not just the reports. The images can be reviewed again by another expert to see whether a bleed was present and missed.
Write down what you remember. Note how the injury happened, what symptoms appeared and when, what tests were done, and what you were told. Memory fades, so do this soon.
Do not wait too long to ask questions. Every state has a deadline for filing a malpractice claim. In Pennsylvania, that deadline is usually two years. There are some exceptions, but the clock can run out fast. Acting early protects your rights.
Talk to a lawyer who knows these cases. Brain hematoma claims are complex. They need medical experts, including radiologists, and a deep understanding of emergency and trauma care. A general lawyer may not be the right fit. A firm focused on medical malpractice will know what to look for.
How Lupetin & Unatin Can Help
We are Lupetin & Unatin. We are a Pittsburgh medical malpractice firm. We focus on serious injury and death from medical errors. Cases involving missed and delayed diagnosis of brain bleeds are at the heart of our work. We know how these errors happen. We know how hospitals and radiologists defend them. And we know how to hold them accountable.
We have handled catastrophic brain injury and wrongful death cases. We understand how a treatable bleed can become permanent brain damage or death when the warning signs are missed and the clock runs out. We know the medicine, and we know how to prove what a careful doctor should have done.
We take a small number of cases so we can give each one real attention. We work on contingency. That means you pay nothing up front. You pay nothing unless we win. There is no risk in finding out if you have a case.
You deserve answers. You deserve to know if this suffering or loss could have been prevented. A short conversation can tell you a lot.
Frequently Asked Questions
You may not know for sure on your own. That is normal. The answer is usually in the medical records and the imaging. We look at how the injury happened, what warning signs appeared, whether a CT was done, whether a visible bleed was missed, and how long everything took. The law asks what a careful doctor would have done with the same information. A careful review tells us whether the care fell below the standard. That review costs you nothing.
In most cases, the deadline in Pennsylvania is two years. For a wrongful death claim, that period generally runs from the date of death. Some exceptions can change the deadline. These rules are tricky. The safest move is to call us soon so we can protect your rights before time runs out.
Nothing up front. We work on contingency. That means we only get paid if we win money for you. There is no fee to talk with us and no fee to review your case. If we take your case and do not win, you owe us no attorney fee. This lets you seek justice without financial risk.
Reach Out Today
If any part of this article sounds like your story, please contact Lupetin & Unatin. Tell us what happened. We will listen. We will review the records and the imaging. We will tell you honestly whether we think there is a case.
A brain bleed can take a life in a matter of hours. A missed diagnosis can change everything. If a hospital or doctor failed you or someone you love, you have the right to seek justice. Let us help you find out what really happened.
Call Lupetin & Unatin today for a free, no-pressure review of your case.