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Director of the Hadassah hospital, Dr. Shlomo Mor-Yosef, speaks as Dr. Felix Umansky, the chief neurosurgeon treating Israeli Prime Minister Ariel Sharon, listens. (AP)
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| By Israel Insider staff and partners January 10, 2006 |
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Prime Minister Ariel Sharon was suffering from an undiagnosed brain disease that can be worsened by the blood thinners he was taking before his massive stroke last week, the Haaretz newspaper reported Tuesday.
If the disease of the blood vessels in the brain had been diagnosed when Sharon suffered a first stroke on Dec. 18, doctors most certainly would have not prescribed the blood thinners due to the risks, a senior doctor treating Sharon told Haaretz. The ailment was discovered only after Sharon suffered a massive stroke last week, Haaretz said.
Doctors interviewed by Haaretz believe that the blood thinners led to the severe brain hemorrhaging that Sharon suffered during his second stroke.
Sharon's brain disorder is called cerebral amyloid angiopathy (CAA), which is diagnosed by brain scans, the doctor close to the case told Haaretz. Sometimes it can be detected only after brain hemorrhaging, the daily said.
Hospital spokeswoman Yael Bossem Levy declined to comment on the report. "We are busy treating the prime minister and fighting for his life and nothing else," she said.
According to a senior medical source, CAA is in some instances a genetic disorder, while sometimes its origin is unknown. The disease is diagnosed by means of interpreting CT and MRI scans, or by performing a biopsy on a small sample of the brain. However, medical literature is also filled with testimony that the disease is very difficult to diagnose, and can sometimes be detected only following a brain hemorrhage.
The doctor who provided the testimony defined the administering of the blood-thinning medication after the first stroke as a "screw up."
A senior doctor told Haaretz Monday night that CAA is one of the main causes of cerebral bleeding in elderly individuals, and that studies in recent years have shown that the administering of blood-thinning medication to individuals with CAA is a "significant factor" in causing cerebral hemorrhages.
Sharon responds to stimuli
The hospital treating Ariel Sharon said Tuesday that doctors will continue reducing his level of sedation and testing his reactions, more than five days after he suffered a massive stroke.
The statement from Jerusalem's Hadassah Hospital said Sharon's condition, unchanged overnight, was critical but stable. Doctors began removing anesthetics on Monday, and Sharon responded to pain stimuli with slight movements of his right leg and arm, they said.
However, doctors said it would be days before they could assess damage to his brain, critical to determining the political future of Sharon, Israel and the region.
Sharon was still unconscious Tuesday morning. Doctors said he was able to breathe on his own, though he was still hooked up to a respirator.
Doctors said Monday that the slight progress Sharon showed Monday after they began withdrawing sedatives that had kept him in a coma since the stroke on Wednesday was just the beginning. Considering the amount of bleeding and the many hours surgeons spent trying to stop it, doctors doubt he will recover enough to resume his duties.
If not, Israel's Cabinet would have to choose a premier to serve until March 28 elections, and the campaign, on hold because of Sharon's illness, could get underway. Acting premier Ehud Olmert was his logical successor.
Sharon was expected to win in a landslide at the head of his new, centrist Kadima Party.
Doctors say evaluation of brain damage is days away
On Monday, doctors at Hadassah Hospital began gradually reducing Sharon's sedatives to rouse him from the induced coma he has been in for five days so they can assess brain damage. They said they won't have a full picture for several days.
"We are just at the beginning of a very long way," said his chief surgeon, Dr. Felix Umansky, briefing reporters for the first time. "It's too early to talk about the cognitive issue."
After the level of sedatives dropped, Sharon started breathing on his own, though he remains hooked up to a respirator and unconscious. He also lifted his right hand and leg slightly in response to pain stimulation, said Dr. Shlomo Mor-Yosef, the director of Hadassah.
Sharon's response is a "very important" sign and indicated his brain stem is working, but it's still too early to assess what impact the massive bleeding he suffered in his right brain would have on his cognitive abilities or on the left side of his body, Umansky said. Doctors will continue lowering the level of sedatives in Sharon's body over the next several days, he said.
Sharon has not yet opened his eyes - though his doctors were hoping he would do so when the sedative levels dropped further - and outside experts cautioned there is no assurance he will wake up at all.
"His chances of survival are better than if the respiratory center had been damaged, but that still doesn't mean he's going to survive," said Dr. John Martin, a professor of cardiovascular medicine at University College in London. Martin said Sharon's weight and age work against him.
Israel TV's Channel 2 quoted Sharon's advisers, who are keeping watch by his side, as saying he also responded to words in some fashion. Classical music, including Mozart, is being played in Sharon's room.
The doctors' final assessment on Sharon's brain damage will be presented to Attorney General Meni Mazuz, who will then decide whether to declare the prime minister permanently incapacitated.
In the event of such a ruling, the Cabinet would have to elect a new prime minister within 24 hours, from among the five sitting Kadima Cabinet ministers who are also lawmakers, said Justice Ministry spokesman Yaakov Galanti.
Olmert, who is among the five, was named acting prime minister after Sharon's stroke, and can serve in the role for 100 days, which would carry him through the elections.
The AP contributed to this report.
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