Prime Minister Ariel Sharon remains in serious condition,
even as his doctors reduce the drugs given to him and he
shows signs that his brain is working. On Tuesday
Ha'aretz reported that after examining CT scans taken
during his current stay, doctors concluded that he was
suffering from cerebral amyloid angiopathy (CAA), a disease
of the blood vessels in the brain. Someone with this problem
would not usually be given anticoagulant drugs, as Sharon was
given after his first stroke on December 19. The blood-
thinning medication causes a great risk of severe
hemorrhaging for someone with this condition.
As doctors gradually reduced the drugs given to him, Sharon
began to breathe spontaneously and also moved his right hand
and right leg "slightly but significantly" in response to a
pain stimulus. Some reports said that he was also responding
to voices and conversation and he moved his left side as
well.
The anesthesia drugs administered to Sharon have kept him in
a state of induced coma to help his brain recover from three
bouts of surgery performed last week to stop the
hemorrhaging. Soon after the first reduction, Sharon began to
breathe by himself, although he remains connected to a hi-
tech ventilator that takes over automatically if he does not
breathe properly for himself. The prime minister's vital
signs of blood pressure, breathing rate, pulse and
intracranial pressure remain "within the normal range."
Prof. Felix Umansky, head of Hadassah's neurosurgery
department who participated in the three lifesaving brain
operations performed on Sharon and who has been with him "24
hours a day," said that it would still take days or more
until it became clear how much brain damage he suffered in
his right hemisphere or elsewhere. It is too early to predict
his cognitive abilities, the neurosurgeon added. Progress, he
said, is different in each patient.
Asked when it could be said that Sharon was out of danger,
Umansky replied: "It's hard to say. Surely when he can speak
to us, when he is conscious, when he can sit and all systems
work and there is no infection or complication."
Another expert said that it can take weeks for brain edema to
go down and days to know about his brain functioning.
Medicine is not an exact science, and neurological
improvement is slow.
The chances that Sharon will survive his massive stroke are
"very high. He is a very strong man, and he is getting the
best care," Dr. Jose Cohen, the neurosurgeon who has
performed three operations on Sharon, said.
Cohen warned, however, that the prime minister remained in
serious condition, and noted: "He will not continue to be
prime minister, but maybe he will be able to understand and
to speak."
Sharon's secretary said he had been working more than the
recommended four hours before his second stroke and part of
that was writing thank you notes to well-wishers from his
first stroke.
According to a senior medical source, in some instances CAA
is 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, the disease is very difficult to diagnose,
and can sometimes be detected only following a brain
hemorrhage.
Critics have raised numerous questions since Sharon's
hospitalization regarding his medical supervision over the
past two weeks; the administering of the blood-thinning
medication; the dosage administered; the medical and
laboratory supervision in the wake of administering the blood-
thinning medication; and the decision to perform the cardiac
catheterization as well as its timing.
Rabbi Nosson Grossman wrote that just before the stroke which
took place on January 4, Yoel Marcus of Ha'aretz wrote
a column for the "new year" about how difficult it is to
foresee events. He noted that no foresaw that Gush Katif
would be evacuated without a drop of blood being spilled or
any really serious conflict, that Netanyahu would resign from
Sharon's government, that Sharon would leave the Likud that
he founded, that Tzachi Hanegbi and Shimon Peres would leave
their long-time political homes and find themselves together
in Kadima, or that the healthy, powerful Sharon would suffer
a stroke that would cast a shadow on his abilities. Marcus
ended with a flourish: "No part will get the number of
mandates now predicted for it. But one thing is clear: Sharon
will be the next prime minister!"
Less than 48 hours later, Sharon even ceased to serve as the
current prime minister. Hakol beyedei Shomayim.
