67 treatment of inmates.249 Moreover, lack of adequate medical assistance could be considered per se a violation of Articles 5(1) and 5(2) of the Convention depending on the specific circumstances of the person, the type of ailment, the time spent without medical attention and its cumulative effects.250 221. In this respect, the Court notes that from the medical record of Mr. Vélez Loor it is noted that, inter alia, on March 20, 2003, Mr. Vélez Loor was evaluated for migraines and dizziness, the product of a former cranial fracture, which according to the physician had been there for almost a year; therefore a CAT scan of the brain was prescribed251; on April 10, 2003, Mr. Vélez Loor was summoned for a medical evaluation but he refused to go; however, the physician, upon reviewing his medical record, determined that the inmate had a fractured skull and that a CAT scan had not been carried out, for which he opted to discard a brain injury with the ordered CAT scan,252 and on April 22, 2003, Mr. Vélez Loor was examined for headaches and dizziness, as the result of a former cranial fracture and a CAT scan was prescribed; however, the CAT scan was not performed due to its cost.253 222. The Court notes that, despite its recurring problems of migraines and dizziness, and the need determined by the physicians who treated him for which a CAT scan was necessary, said scan was never performed and Mr. Vélez Loor did not receive adequate and timely medical care in relation to this ailment, which could have had unfavorable consequences for his current health condition, and it is contrary to the dignified treatment due. According to expert witness Flores Torrico, “the headaches, migraines, blurred vision, tearing, vertigo and dizziness experienced by Mr. Vélez Loor can perfectly relate to the blow he received to his head by a blunt object, by which he sustained an injury and a scar […] in the right front-parietal region.”254 223. Consequently, the Court finds proven that the medical care services to which Mr. Vélez Loor had access to, were not provided in a timely, adequate, and complete manner, given that he did not receive specialized medical treatment and medicine for the apparent cranial fracture he suffered, and it was neither duly treated. 224. In sum, the representatives sustained that the conditions of imprisonment to which Mr. Vélez Loor was subjected to, "constituted cruel, inhumane, and degrading treatment,” "[d]uring the ten months he was in custody of the Panamanian authorities [...] where he lived in inhumane conditions, far from the merited respect to his dignity.” 249 Cf. Case of Montero Aranguren et al. (Detention Center of Catia), supra note 207, para. 102 250 Cf. Case of García Asto and Ramírez Rojas, supra note 99, para. 226; Case of the Miguel CastroCastro Prison, supra note 27, para. 302, and Case of Montero Aranguren et al. (Detention Center of Catia), supra note 207, paras. 102 and 103. 251 Cf. Note of Dr. Guillermo A. Garay M. of March 20, 2003 in the medical file of Mr. Vélez Loor in the Complex of La Joya-Joyita (case file of the evidence, tome VIII, annex 53 to the response to the application, folio 3609). 252 Cf. Communication of the Clinic of La Joyita to the Director of La Joyita Penitentiary Center of April 10, 2003 (case file of the evidence, volume III, annex 53 of the answer to the application, folio 3612); Medical note of Physician Mastellari of April 10, 2003 in medical file of Mr. Vélez Loor of Complex La JoyaJoyita (case file of the evidence, volume III, annex 53 of the application, folio 3609), and Note N° 208DGSP.DAL, supra note 69. 253 Cf. Note N° 208-DGSP.DAL, supra note 69, and Official Letter N° 450-SP issued by the Head of the Prison Healthcare of the Ministry of Interior and Justice addressed to Jesus Vélez Loor on April 22, 2003 (case file of the evidence, volume VIII, annex 53 of the answer to the application, folio 3613). 254 Expert opinion rendered by Marcelo Flores Torrico at the public hearing held before the InterAmerican Court on August 25, 2010.