Surgical Negligence During Neurosurgery

While strokes are the most common cause of locked-in syndrome, the condition can follow a procedure on the brain: aneurysm coiling, mechanical thrombectomy, or posterior fossa surgery. If your loved one woke from a procedure aware but unable to move or speak, you deserve clear, honest answers about what happened during their care.

When a Procedure Meant to Protect the Brain Leads to Locked-In Syndrome

Most families learn about locked-in syndrome after a stroke. A smaller number arrive by a different road. Their loved one went into a procedure to treat an aneurysm, clear a blocked artery, or remove a growth near the brainstem. They came out fully aware but unable to move or speak.

Medical literature recognizes this outcome. There are case reports that describe this rare but devastating complication that can follow neurosurgical and neurovascular interventions. Its rarity does little to soften the reality for the family living with it.

This kind of loss carries its own weight. The procedure was meant to help. Many families agreed to it with hope, sometimes after hearing it was the best option available. Learning that it led to permanent paralysis can bring grief and confusion. It can also bring a strong need to understand what happened.

A devastating outcome, on its own, does not prove anyone made a mistake. Every brain procedure carries known risks. Skilled teams following accepted practice sometimes face complications they could not prevent. In other cases, a complication traces back to a decision, a technique, or a missed warning sign that should have been handled differently.

How Neurosurgery Can Injure the Brainstem

The brainstem is small and depends on a network of fine blood vessels branching from the basilar and vertebral arteries. Procedures that work inside those vessels, or near the brainstem itself, carry a risk of interrupting that blood supply or injuring the tissue directly.

Aneurysm Coiling

Surgeons use coiling, also called endovascular coiling or endovascular embolization, to treat an aneurysm. A thin catheter travels from a blood vessel in the groin up into the brain, where the physician places soft metal coils inside the aneurysm. The coils fill the space and seal it off so it can no longer bleed.

The most serious risk is a clot forming on the coils or a nearby branch vessel becoming blocked. This risk weighs most heavily with aneurysms on the basilar artery, because its small branches feed the ventral pons, the part of the brainstem that carries movement signals to the body. Blockages or aneurysms involving the basilar artery and ventral pons can lead to locked-in syndrome. Some patients develop it even after a procedure that appeared technically successful.

Care can fall short when a case is poorly selected or planned, or when medications to prevent clotting are mismanaged. It can also fall short when coils protrude into the main vessel, or when warning signs on the imaging during the procedure are not addressed.

Mechanical Thrombectomy

Thrombectomy removes a clot blocking a major artery in the brain. A catheter carries a retrieval device or suction tube to the clot and pulls it free, restoring blood flow. When it works, thrombectomy can prevent the very brainstem stroke that causes locked-in syndrome.

Complications occur even in experienced hands. A registry study of thrombectomy, published in Stroke, found procedural complications in about 8% of patients. The most common complication was a clot fragment traveling to a new area of the brain.

Care can fall short when a team continues attempts without reassessing, when a device is used improperly, or when a perforation or new blockage goes unrecognized during or after the procedure.

Posterior Fossa Surgery

The posterior fossa is the space at the back and base of the skull that holds the brainstem and cerebellum. Surgeons operate here to remove tumors, treat blood vessel malformations, or relieve pressure. Because the brainstem sits at the center of this space, even small missteps can have lasting effects.

Known risks include direct injury to brainstem tissue, damage to the tiny arteries that supply it, and swelling or bleeding after surgery. Many teams use intraoperative neurophysiological monitoring during these operations. This monitoring tracks nerve signals in real time and alerts the surgeon to possible injury.

Care can fall short when monitoring is not used where it is expected, or when its alerts go unanswered. It can also fall short when surgical technique near the brainstem falls below accepted practice, or when swelling or bleeding after surgery is not caught and treated promptly.

Were You a Victim of Medical Negligence?

If a delayed diagnosis led to permanent harm, you may be entitled to compensation. Speak with our legal team today.

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Known Risk or Preventable Error? How the Difference Is Evaluated

Negligence depends on one central question: did the care meet accepted medical standards? Independent experts answer it by reviewing the full record, often looking at the following:

• Informed consent: Were the patient and family told about brainstem risks and the alternatives?
• Decision-making: Was the procedure appropriate, and chosen at the right point in care?
• Technique: Was it performed within accepted practice?
• Monitoring: Did the team respond to neuromonitoring alerts or changes on imaging?
• Recognition afterward: Was a new injury identified promptly?

That last area deserves close attention, because locked-in syndrome can resemble coma or lingering sedation.

Many complications happen despite excellent care. A careful review exists to learn which kind of case this is. For families, that answer can bring clarity either way.

What Families May Notice, and Questions Worth Asking

Families often sense a change before anyone names it. After a brain procedure, you may notice that your loved one is slow to wake, responds only with their eyes, or is described as unresponsive while you feel sure they are aware. Trust what you see, and share it with the care team.

Calm, specific questions can help:

• Can we test for yes-or-no answers using eye movements or blinks?
• Has the brainstem been examined with imaging since the procedure?
• What happened during the procedure, and were there any complications?
• Who can we speak with if we have more questions?

Speak to your loved one while you ask. They may hear every word, and including them honors their place in the conversation. Asking questions is one of the most caring ways to advocate for someone who cannot speak in the way they once did.

How Newsome Law Helps Families Find Answers

Newsome Law helps families understand what happened during a loved one’s care. Our team gathers the complete medical record, works with independent medical experts to review each decision, and builds a life care plan that reflects your loved one’s awareness and needs. We keep your family informed and include your loved one along the way. When you’re ready to talk, reach out, and a locked-in syndrome attorney from our firm will listen to your family’s story with care. We’ll never pressure you to move forward with any action.

We know locked-in syndrome is very costly. That is why we take cases on a contingency basis. You pay us nothing unless we recover compensation.

Read more about Rich Newsome

Rich Newsome

Catastrophic Injury Locked-In Syndrome Attorney

Rich Newsome is a dedicated attorney specializing in catastrophic injury and medical malpractice cases. With over 25 years of experience, she is committed to advocating for victims and their families, ensuring they receive the justice and compensation they deserve.