Doctors Say Sharons Failure to Wake From Coma Not a Good Sign

By STEVEN GUTKIN

Doctors say Sharons failure to wake from coma not a good sign

JERUSALEM Prime Minister Ariel Sharons failure to wake up from a coma nine days after suffering a massive stroke does not bode well for his recovery, some doctors said Friday.

With extensive brain damage looking likely, Israelis have begun to look ahead to life without Sharon.

Sharon, 77, remained in critical but stable condition Friday, showing no change from the previous day, said Hadassah Hospital spokesman Ron Krumer.

Israels Channel 10 TV and Army Radio cited Hadassah officials as saying they were worried Sharon has shown no signs of awakening, even though doctors have begun weaning him off heavy sedatives used to keep his blood pressure in check and give his brain time to heal.

However, Krumer and outside experts cautioned its too early to make conclusions about Sharons long-term prospects. Hes still receiving minimal amounts of sedatives, Krumer said, adding, The period of time it takes a patient to wake up from such a condition after undergoing such an event differs from one patient to another.

Sharons two sons have been playing classical music by his bedside in an effort to rouse him. Although doctors induced a coma, the condition may also be due to the Jan. 4 stroke itself.

Channel 1 TV cited one of Sharons neurosurgeons, Dr. Felix Umansky, as saying he was optimistic Sharon would emerge from his coma within 10 days.

But several outside experts said the prognosis looked poor.

People can often wake up over a period of weeks and months, but if they wake up faster, obviously it bodes better, said Dr. Howard Riina, professor of neurological surgery at Weill Cornell Medical College in New York. The fact that hes not completely awake at this point does not bode well for a good neurologic recovery.

Dr. Nick Ward, a neurologist at Londons University College, was more blunt.

Its a bad prognostic indicator, he said. Hes not going to get back to normal, thats for sure.

Maurizio Miglietta, chief of Trauma and Critical Care at NYU Medical Center, said cerebral bleeding in the wake of Sharons stroke means that hes not the average stroke patient. A longer coma is probably to be expected, he said.

Neurosurgical patients sometimes dont wake up for a week or even two weeks afterwards, Miglietta said. Its not uncommon.

Doctors have reported only slight improvement in Sharons condition in the past several days, centering on small movements of limbs in response to pain.

A brain scan on Thursday showed the remnants of blood in his brain have been absorbed, the hospital said. In response, doctors removed a tube they had inserted into his skull to relieve pressure on his brain.

The longer it takes for Sharon to regain consciousness, however, the greater the concern about extensive brain damage.

Sharons stroke and subsequent surgeries plunged both Israeli politics and Mideast peace prospects into turmoil, as he was seen as the politician best positioned to end Israels conflict with the Palestinians.

In a sign that Israelis are moving on, however, the prime ministers condition was taken off the front pages of several Israeli newspapers Friday. Television has returned to normal programming, and many Israelis watched a basketball game on TV Thursday night.

Acting Prime Minister Ehud Olmert met with two U.S. envoys Friday to discuss Jan. 25 Palestinian parliamentary elections, which have stirred wide concern because of Hamas militants participation in them.

Also Friday, Israel Radio reported Olmert will appoint the popular justice minister, Tzipi Livni, as the new foreign minister, making her the most senior woman in the government.