Sometimes a headache is just a headache, other times…

By Frank Natale, Malpractice Associate

A condition which can cause headaches and potentially lead to aneurysms is known as a cerebral arteriovenous malformation.
Arteriovenous Malformation (AVM) is an abnormal connection between arteries and veins, bypassing the capillary system. Although many AVMs are asymptomatic, they can cause intense pain or bleeding or lead to other serious medical problems.
The most general symptoms of a cerebral AVM include headaches and seizures with more specific symptoms occurring that normally depend on the location of the malformation and the individual. Such possible symptoms include:[2]
• Difficulties with movement coordination, including muscle weakness and potentially paralysis;
• Dizziness;
• Difficulties with speech and communication;
• Difficulties with everyday activities;
• Abnormal sensations (numbness, tingling, or spontaneous pain);
• Memory and thought-related problems, such as confusion, dementia or hallucinations.
Cerebral AVMs may present themselves in a number of different ways:
• Bleeding
• Sudden onset of severe headache. May be described as the worst headache of the person’s life.
• Seizure or brain seizure.  Depending on the place of the AVM, it can cause loss of vision in one place.
• Worsening of neurologic functions.

Treatment for brain AVMs can be based on symptoms, and is usually coordinated by a  neurologist for symptoms such as: seizures, headaches, or focal neurologic deficits.
AVM-specific treatment may also involve endovascular embolization, neurosurgery or radiosurgery.  Embolization (cutting off the blood supply to the AVM) with coils, or other materials introduced by a radiographically guided catheter, may be used in addition to neurosurgery or radiosurgery, but this type of treatment is rarely successful in isolation except in smaller AVMs. Gamma knife may also be used to eliminate the AVM in some cases.

Follow up care is extremely important where invasive (surgery, lasers, coils) care is undertaken.  For example people who undergo these procedures may have swelling of the tissue around the AVM, atrophy (wasting away or dying of tissue) from a lack of blood supply to the area, and other effects.  It is extremely important to understand what options your physician would consider to treat any of those effects.  Discuss those in detail with your family and the people you rely on for medical care.

If you or a loved one experiences complications arising from the treatment of a cerebral AVM, please feel free to contact Frank Natale at Bowers Law to discuss any legal options you may have. We can be reached any time at 410-885-6200.

Cecil County’s Top 5 “Hot Spots” for 2016 Accidents #4

We’re continuing out countdown of the most dangerous accident spots in Cecil County, Maryland for the calendar year 2016. Last week we saw the 5th most dangerous accident intersection(s) as rated by the cases my office handled in the 2016 calendar year.

4. Rt 40 and Rt 213 (Bridge St/Augustine Herman Highway)


If you were to have asked me what intersections I thought were the most dangerous in 2016 without actually looking at the numbers this one would have been my guess for the top spot. Surprisingly, this intersection ranked number 4 on the overall list for 2016 accidents.

Yes. That mean’s there are 3 intersections in Cecil County Maryland that we handled more accidents from than the interchange between Rt 40 and Rt 213!

This is likely one of the busiest intersections in Cecil County, right in the heart of Elkton. The intersection of 2 major county arteries is also the intersection of many many vehicles, not in a good way!

The lights here are on a timed sequence, but they’re not entirely consistent. If you’ve ever tried to turn left onto 213 from the eastbound Rt 40 lane, you know that left arrow lasts maybe 3 or 4 cars…if everyone is paying attention!

Be careful traveling through this intersection, and don’t try to “speed up” and beat any lights here, otherwise you might become a client of ours, or even worse create a client for our office. Don’t just be careful here, but also be careful in our #3 most dangerous intersection for 2016.

If you’re injured in an accident in Cecil County, or anywhere in the State of Maryland please call our office at 410-885-6200. We’re happy to discuss your claim, and handle all dealings with insurance companies on your behalf. Most importantly, we don’t charge you anything up front, and only get a fee if we are successful in getting you money.

Sometimes it just takes hiring an attorney

I was recently hired by an Elkton, Maryland resident to represent him with respect to a work related injury. He originally filed a claim due to the injury, and was sent to a doctor. When his condition did not improve, the doctor suggested that his symptoms were indicative of a meniscus tear, and suggested an MRI to verify the assumption. The insurance company denied the request of the doctor for the MRI, and wanted the injured worker to return to work. Due to his frustration, the client found and reached out to me for representation. Upon hiring me, I entered my appearance with the commission, and sent a standard letter putting the insurance company on notice that I was representing him on behalf of the injury claim. Within 24 hours, and without my even picking up the phone to call the insurance company due to my own busy trial schedule, I received a call from my client letting me know that his MRI had now been approved!

Not all situations are this simple, and most require more of a fight. The simple fact remains, however, and the moral of this story is simple. If an insurance company sees an opportunity to deny a claim, or part of a claim, and you are not represented by an attorney, many will attempt the seize the opportunity to save some money, and hope that the injured party will just move on, give up, and walk away.

This isn’t just a worker’s compensation issue. This works the same way for any injury situation.  It’s always advisable to at least discuss these claims with an attorney prior to making any big decisions. To discuss an injury matter with my office for free, contact me at any time at (410) 885-6200.

What they don’t teach you in law school

There’s a lot about the practice of law, and the reality of law that just isn’t taught in law school. In fact, not only do they not teach it in law school, but you don’t learn anything about the reality of the cases when reading opinions.

The famed “Burger King” case involving personal jurisdiction from Civil Procedure–we learn that the defendant purposefully availed himself to florida, but who won the case? We never know any of this stuff, nor do we really find out. If a case gets remanded for a new trial, or new trial on a given issue, we never really know the outcome, we only find out who won the appeal.


This summer I am doing an internship at the Public Defender’s office in Cecil County, approximately 12 minute commute from where I live. Here i get into the real dirt of things, but I still have questions. I am taking Constitutional Criminal Procedure this summer, and am currently reading a recently case Florida v. Jardines. The court upheld that a search of the premises was in violation of the 4th amendment, so it gets suppressed. The case involves a guy who was allegedly growing and trafficking marijuana. I presume that the plants in question were confiscated, and I can assume that other processed product and cash was also confiscated. His lawyers motioned for suppression of the evidence, eventually won, and SCOTUS upheld the decision. So does he get his stuff back?


These are the crazy questions that go through my mind when reading these things. I guess its my fault for looking too deep into the cases, or trying to find the actual situation that happened behind the case.


Oh well, should be a fun semester, full of hands on practical learning.

Year 2

I know things got real busy at the end of last year. I got tied up with life, family, my wife’s surgery, and classes.

Turns out I got through the spring, as well as a summer semester, and now am in the fall semester of my second year.

Courses this year include:
Professional Responsibility

Labor Law

Constitutional Law 1

Insurance Law


Should be a fun semester, I’ll do what I can to post regularly.

I didn’t really read this weekend! Uh oh

So this should be an interesting week. Despite having an extra day off for MLK day yesterday, I failed to really do any of the required reading for my classes this week. I am fairly non-stop when I get to work, in fact half of the time I am taking calls related to work before even getting there. Having 2 kids and the associated family duties sure makes time management difficult. Normally I would use the train ride into Baltimore from Perryville for my reading time, but I stayed home to help get the kids ready, and didn’t make the train. Its not incredibly easy, or legal for that matter, to read while driving. I must relegate some of my ability to undertstand the material to Daniel Fessler and his fantastic and seemingly timeless PMBR audio recordings for contracts, but while the bar testable concepts and materials are covered in the audio, the specific cases discussed in classes are not.

Fortunately the reading for Civ Pro for tuesday’s class was merely 2 cases, covering 3 whole pages. Those were somewhat simple to knock out. Fortunately, one of the things that the PMBR audio has helped me to do, was understand the concepts, and read just the cases themselves if I am in a pinch, and not necessarily the commentary of the authors. Note: The guides on the right hand side (Examples and explanations) are fantastic guides for solidifying the concepts in the main books, providing additional hypotheticals and fact patterns for studying.

I also suggest buying these books (click my links so I make a couple cents when you buy them) because there are only so many sources for law school exam fact patterns. This is not to say that your professor(s) will use books like this, but last semester I can say that there were some glaring similarities between some of the fact patterns in Examples & explanations and the fact patterns on at least one of my exam questions.

One semester down….all the rest to go

I have survived…the first semester of my 1L semester at the University of Baltimore School of Law. I’m happy with the grades, but more happy to be moving forward onto another semester. Looking back, it was quite an interesting semester to have survived doing as well as I did, considering the following:

  • The birth of my son William on October 6th (I somehow managed to not miss a class as a result of this)
  • Being involved in a fairly serious automobile accident on November 11th
  • Working full time for what is becoming a much higher volume law firm
  • Trying to sell a house
  • Trying to buy a house
  • Several other things that I’m probably forgetting

Its been a fun semester, and I would have to say that aside from the overall goal of becoming a lawyer, I’m glad that I’m in law school. A lot of people are here for a lot of different reasons, and my reasoning is quite straight forward: to become a lawyer. As the winter break came closer to an end, I found through several conversations with other classmates, that I’m pretty much the only one who was itching to get back to work.