Areas of Expertise
Mr Oliver Richards, Consultant Paediatric Neurosurgeon | GMC 7271223
Clinical Foundation for Expert Opinion
My expert opinion draws on active consultant practice in paediatric neurosurgery at Alder Hey Children's Hospital and an international fellowship at SickKids Toronto. The areas described below reflect conditions I manage regularly in clinical practice and in which I am able to provide objective, well-grounded and independent opinion.
Please Note Before Instructing
Instructions are accepted on a records and papers basis across all of the areas below. Opinion is therefore provided on breach of duty and causation, and on prognosis so far as it can be addressed from the records. This is a records-based practice and claimants are not examined. A condition and prognosis report of that kind is a separate instruction, and in paediatric neurosurgical claims is usually directed to a paediatric neurologist, neurorehabilitation physician or paediatrician.
Jump to: Hydrocephalus & shunts · Brain injury · Spinal disorders · Brain tumours · Cerebrovascular disease
Hydrocephalus & Shunt Complications
Hydrocephalus management forms a core part of my day-to-day clinical practice. I undertake CSF diversion procedures including ventriculoperitoneal shunting, endoscopic third ventriculostomy and shunt revision surgery. This extends to young adults whose hydrocephalus began in childhood, including care around the transition to adult services.
In medico-legal proceedings, hydrocephalus cases commonly involve questions around delayed diagnosis of shunt malfunction or infection, the appropriateness of the chosen surgical strategy, timing of intervention, and the management of complications. The questions I can address include the standard of care applicable at the time of treatment, and whether any departure from that standard caused or contributed to the harm alleged.
Typical Case Types
- Delayed diagnosis of shunt malfunction
- Shunt infection — diagnosis and management
- Timing and appropriateness of shunt revision
- Complications of CSF diversion surgery
- Endoscopic third ventriculostomy — selection and outcome
Traumatic Brain Injury
Traumatic brain injury in children is a significant component of paediatric neurosurgical practice. I manage both operative and non-operative paediatric TBI, including extradural and subdural haematomas and depressed skull fractures, as well as injuries managed without surgery such as diffuse axonal injury.
In personal injury proceedings, expert opinion is commonly sought on the nature and severity of the injury, the appropriateness of initial assessment and management, and prognosis. My opinion is directed to the neurosurgical aspects of the case — assessment, imaging, indications for intervention, timing of treatment, and causation where it falls within my expertise — on the basis of the available records. The wider consequences of a brain injury, including cognitive, educational and care needs, are matters for the relevant non-surgical specialties. Where a prognosis opinion depends on examining the claimant, a separate instruction to an expert able to examine will be required.
Typical Case Types
- Paediatric head injury — operative and non-operative management
- Extradural and subdural haematoma
- Depressed skull fractures
- Delayed or missed diagnosis of intracranial injury
- Neurosurgical prognosis following TBI, so far as it can be addressed from the records
Paediatric Spinal Disorders
Paediatric spinal neurosurgery encompasses a wide range of congenital and acquired conditions. I manage spinal cases as part of my consultant practice, with experience across the spectrum of conditions encountered in a busy tertiary paediatric neurosurgical centre.
Medico-legal cases in paediatric spinal surgery frequently involve questions around delayed diagnosis of spinal cord compression or tethered cord, the management of spinal dysraphism, and the assessment of perioperative complications. I can provide opinion on breach of duty and causation in these cases, and on prognosis so far as it can be addressed from the records. My opinion is confined to neurosurgical spinal pathology and does not extend to orthopaedic spinal deformity such as adolescent idiopathic scoliosis.
Typical Case Types
- Tethered cord — diagnosis, timing of surgery, outcome
- Spina bifida and spinal dysraphism
- Intramedullary spinal cord tumours
- Craniocervical junction abnormalities
- Spinal cord injury — causation, and prognosis on the records
- Perioperative spinal complications
Paediatric Brain Tumours
Paediatric neuro-oncology is a subspecialty area of my current practice at Alder Hey, where I am a member of the neuro-oncology multidisciplinary team. My operative practice covers the range of paediatric CNS tumours, including posterior fossa tumours, craniopharyngiomas, pineal region tumours, and high-grade gliomas.
My fellowship at SickKids Toronto provided further experience in complex paediatric neuro-oncology.
Medico-legal cases in this area commonly involve delayed diagnosis, the appropriateness of surgical decision-making, operative complications, and prognosis. My opinion is confined to the neurosurgical aspects of care; decisions on chemotherapy, radiotherapy protocols and surveillance intervals are matters for a paediatric oncologist. These are technically demanding cases, and I ask potential instructing solicitors to contact me to discuss suitability before formal instruction.
Typical Case Types
- Delayed diagnosis of paediatric brain tumour
- Surgical decision-making and operative planning
- Posterior fossa tumours — surgery and complications
- Craniopharyngioma — management, and prognosis on the records
- Pineal region tumours
- High-grade glioma — treatment and outcome
Paediatric Cerebrovascular Disease
Paediatric neurovascular disease forms part of my subspecialty practice at Alder Hey, where I manage the neurosurgical aspects of these cases alongside the wider multidisciplinary team, including the treatment of associated hydrocephalus.
These lesions are rare and their management is highly specialised. I ask instructing solicitors to contact me to discuss suitability before formal instruction, so that cases turning principally on endovascular treatment or on specialist neurovascular decision-making, where another opinion would be better suited, can be identified at the enquiry stage.
Typical Case Types
- Hydrocephalus secondary to a vascular malformation
- Paediatric intracranial haemorrhage — recognition and management
- Timing and coordination of neurosurgical treatment
- Perioperative complications of neurovascular surgery
Is This Case Within My Area of Expertise?
If you are unsure whether a case falls within my area of expertise, please contact me with a brief summary of the clinical issues. I will respond promptly to confirm whether I am able to assist, without any obligation on either side.
Make an EnquiryDiscuss Your Case
Contact me with a brief summary and I will confirm availability and timescales within two working days.
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