http://www.azcentral.com/arizonarepublic/news/articles/0107sharon07.html
Sharon's recovery unlikely
Wire services Jan. 7, 2006 12:00 AM
JERUSALEM - Doctors rushed Prime Minister Ariel Sharon to the operating room on Friday for a third time after finding new bleeding in his brain. After five hours of surgery, the doctors said, he remained in critical but stable condition.
Doctors said they managed to halt the bleeding and took measures to relieve pressure that had built up in Sharon's skull after a massive cerebral hemorrhage he suffered Wednesday night.
After the five-hour operation, Hadassah University Hospital's director, Dr. Shlomo Mor-Yosef, described Sharon's condition as "difficult but stable." The Israeli leader, still in a deep coma induced Thursday by doctors, was returned to the hospital's neurological intensive-care unit.
Despite what Mor-Yosef described as a "significant improvement in the way (Sharon's) brain looks," there did not appear to be any change in the prime minister's overall grim prognosis. Aides and doctors have said that even if the Israeli leader survives, the irreversible brain damage he probably has suffered will preclude a return to his duties.
Outside experts said Friday's measures probably had done little more than stave off the immediate crisis.
"They probably accomplished the initial goal of keeping him alive," said Dr. Keith Siller, a neurologist and medical director of the New York University Comprehensive Stroke Care Center. "He's still far from being out of the woods. Overall, his prognosis is still very, very poor."
As the 24-hour Jewish Sabbath began at dusk Friday, religious leaders continued to call for prayers for Israel's leader.
Sharon fell ill Wednesday night at his sheep ranch in the Negev Desert on the eve of what was to have been a procedure to repair a congenital heart defect.
That defect, a tear measuring about an eighth of an inch wide, was thought to have contributed to a minor stroke he suffered Dec. 18 by allowing a blood clot to slip through and reach his brain.
Treatment of the initial stroke involved of blood thinners, which made it more difficult for doctors to halt bleeding after his subsequent massive hemorrhagic stroke.
Debate continued Friday in Israel over whether doctors had acted unwisely by administering the blood thinners, by allowing Sharon to resume a strenuous working schedule days after the minor stroke, and by transporting him to Jerusalem in a 90-minute ambulance ride rather than either airlifting him or rushing him to a hospital closer to his ranch.
Doctors said Sharon probably will remain in his medically induced coma until at least Sunday and perhaps longer to allow for swelling to go down and to aid in his overall recuperation.
Until physicians try to bring him out of the coma, it will be impossible to assess the full extent of the neurological damage, but doctors have indicated it is expected to be severe.
Sharon's two sons, Omri and Gilad, were at their father's bedside, taking turns sleeping in a room next to his, and aides have been keeping a round-the-clock vigil. Sharon's sons, particularly Gilad, to whom Sharon is close, were thought to have been empowered to make decisions regarding their father's treatment.
Some eminent Israeli neurologists have been quoted anonymously in Israeli media reports as saying that measures taken so far, the three lengthy and invasive surgeries to halt bleeding, have been more extreme than normally would be employed in the case of a patient of Sharon's age and condition. A month short of his 78th birthday, the Israeli leader is grossly overweight, estimated to carry more than 300 pounds on a 5-foot-7 frame.
Siller, the New York University neurologist, described the surgeries carried out so far as "lifesaving maneuvers."
"We don't typically operate on hemorrhagic strokes," he said. "When the hemorrhage is this massive, we usually don't recommend heroic measures."