I have recently stumbled upon the following article, and I think this is a really important and serious issue in Medicine in general, so I would like to raise awareness to the topic:
I’ve reached it while pondering about my partner and wife. She is fighting and recovering from a cerebellar AVM bleed and craniotomy on October 2018. Looking back now to her history, I’ve pinpointed moments in which I think that the problematic discussed in the article have raised.
Two years ago, when she woke up in the morning with a huge headache and not being able to see anything at all for 30 minutes. We rushed to the nearest hospital, and by the time we got there, her vision was back and the headache was gone. The consulting doctor gave her an aspirin (!!!), and said that was only probably because she raised too fast from the bed. She has argued - and me as well with the doctor - but he did not want to do any further exams and sent her home.
Not convinced, she went on to schedule appointments with 2 different neurologists (which here in Germany, is a quite difficult task). After weeks of waiting, she has described what happened and both basically just said “that’s probably just a bad migraine, it’s common for woman in your age, and you’ve had it before”. Despite of she asking for them to at least do a CT scan or an MRI, they did not want to order the exam. By that time we were both students, with very little money, and we needed the doctors to order the exam to be able to have it covered by our health insurance - so if they didn’t, we had no way of ordering it. So for the lack of a better option, she decided to trust their opinion for the moment.
Let’s jump to last year, on the week of her bleeding. She has again woken up by a big headache, though this time with no vision problems. She did not, this time, want to go to a hospital, neither to talk again to a neurologist; being that the last time was absolutely disappointing, and they’ve said it was just migraines. It could be though too, a form of internalization of the “I’m making too much fuzz for nothing” discourse, which is unfortunately too often put on women since childhood…Though I might be utterly wrong here.
Two days later… she had the headache again, and this time, I was with her and we called an ambulance. Even in the ambulance, the paramedics were saying (while her eyes were each moving to a different direction) “that’s just probably labyrinthitis or a bad migraine” (!!!). Luckily, then, finally, she was correctly diagnosed when reaching the hospital. Turns out she was having a big bleeding in an AVM deep within her Cerebellum, which we have never known nor heard about before!!
It pains me to look back and wonder how our story could have been so much different, if only those 3 different doctors two years ago had ordered a simple CT exam.
Yes, misdiagnosis happens all the time. And yes, diagnosis and prognosis are all based on previous studies and standards. But it so does happens that misdiagnosis might be happening more to young woman for the worst reasons possible; as well as, doctors should be a little more aware that there will always be that 1 case in the year, when a huge headache in someone young is not a simple migraine, but something far more problematic - even if the standards say the chance is 1 in 10000. This not to even begin talking about the gender discrepancy that sometimes occur within the studies that compose the standards themselves…
Anyway, I know I am a man but I wanted to raise this issue for discussion. Maybe you are a woman, or know of a woman, who has has had similar unfortunate experiences…