Israeli Prime Minister Ariel Sharon, who was hospitalised late on Wednesday to undergo surgery for a brain haemorrhage, was in critical condition and may not recover, a senior political source said. "It looks very bad. I don't know if he will recover," the source said. Sharon "felt ill" and was immediately hospitalised, said the aide. Sharon, 77, was due to visit hospital Thursday morning. An aide to Sharon said Sharon's deputy had been handed over powers.
This is very bad. A few brief points:
1) The hemorrhagic stroke very likely was made worse (indeed, possible) by the blood-thinners (e.g., coumadin) he had been put on for the upcoming umbrella placement in his heart. The blood thinners are standard in that setting, but it would turn a small stroke into a large one.
2) Neurologists and critical care docs can judge eventual recovery from a stroke in the first 72 hours based on clinical symptoms, consciousness and neurologic function in that time. The worse you are at the 72 hr mark, the less likely you are to recover completely, and the lower your eventual plateau of recovery will be (this is formalized in what is known as the Glasgow Coma Score, used by critical care nurses around the world]. The loss of consciousness, near-immediate need for a ventilator, and extensive paralysis are very bad signs.
3) Coma scoring and clinical signs, in addition to predicting recovery/lack thereof, can predict with fair certainty survival in the first couple of weeks. From what I've been reading tonight, Sharon is very critical.
4) Be prepared for reports of emergent surgery to relieve brain swelling ('cerebral edema'). That's a killer early on, and neuro-intensivists have developed techniques to manage it. |
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