Sharon tests 'encouraging'
2006-01-09 22:18
London - Tests showing Israeli Prime Minister Ariel Sharon can breathe and respond to pain are encouraging, but it is still too early to tell whether, or how well, he might recover from his massive stroke, said independent medical experts on Monday.
Sharon's chances of survival look better, but there are still major hurdles ahead that may either kill him or leave him unable to manage anything more than basic functions of heartbeat and breathing, say doctors.
"These are all very small details that are encouraging, but he may not progress much further than these very basic functions that are being observed.
"With the sedation at present, it's impossible to tell what his potential is," said Dr Keith Siller, medical director of the comprehensive stroke care centre at New York University.
Sharon's doctors began weaning him off sedatives on Monday in an effort to see the extent of brain damage caused by the stroke and subsequent complications of re-bleeding and brain swelling.
Brain-function tests
The process is expected to take several days, when doctors will then see whether Sharon regains consciousness.
At that time they will also be able to perform crucial brain function tests.
Breathing, heart rate, blood pressure and pain tests are usually the first basic function studies that take place as sedatives diminish.
Sharon's doctors reported the premier was able to breathe along with the respirator and that he slightly raised his right hand and leg in a pain test.
"That's better than no response, but it's uncertain what it means for the ultimate recovery," said Dr Larry Goldstein, director of the Duke University centre for cerebrovascular disease.
"The functional studies are the be all and end all of this whole thing and that remains to be seen."
Reflex movements
It will be several days before doctors are able to perform those tests, which will determine whether Sharon can respond to verbal commands, speak and move in a co-ordinated fashion.
It is not clear from the Israeli doctors' statement whether the movements Sharon made were reflexes or not.
That depends on where they pinched or poked him.
If the movement was a reflex, the test is less indicative of recovery.
However, if it was a purposeful movement, that would indicate some level of consciousness and that the left side of the brain may be unaffected, Goldstein said.
Location of stroke
One of the main determinants of his recovery is the location of the stroke.
Even though it is known that Sharon suffered a massive stroke on the right side of his brain, doctors have not said exactly where the burst blood vessel is.
"In the right frontal lobe, there could be little in terms of long-term deficits.
"If it's in the back portions of the brain then there could be paralysis, sensory problems and other types of things.
"If it's in the cerebellum, part of the cerebellum can actually be removed and people can do quite well," Goldstein said.
Language function
Experts say that language function, which is governed by the left side of the brain, can be expected to be spared - as long as the swelling that occurred in the days after the stroke did not damage that part of the brain.
Sharon's doctors have not revealed how bad the swelling was.
"They may start seeing several observations that are of course better than nothing, but the big picture is still going to be that he's had a massive stroke," said Siller.
"The damage is already there and I still would stick to the opinion that his prognosis is very, very poor even if he survives."
- AP