- The Washington Times - Friday, January 6, 2006

The odds of a patient surviving more than a month with a massive stroke like the one Israeli Prime Minister Ariel Sharon suffered Wednesday are less than 50 percent, the medical director of the Stroke Center at the Washington Hospital Center said yesterday.

“It sounds really serious … with severe bleeding,” said Dr. Chelsea Kidwell, who is associate professor of neurology at Georgetown University Hospital.

In fact, Mr. Sharon, 77, underwent seven hours of surgery before doctors in Jerusalem could halt bleeding in his brain.

A brain hemorrhage, also known as a hemorrhagic stroke or a cerebral hemorrhage, occurs when there is a rupture of a small blood vessel in the brain.

Brain damage occurs, according to the Harvard Medical School Family Health Guide, because of a lack of blood and oxygen to the tissues, as well as a buildup of pressure from the bleeding.

Although associates of Mr. Sharon say they do not expect him to be able to resume his official duties, Dr. Kidwell, a stroke neurologist, said, “It depends where in his brain the bleeding occurred. For that location will determine what part of the brain was injured, whether it was a part affecting language, or one causing a weakening of the body.”

Associated Press reported yesterday that Mr. Sharon’s stroke occurred on the right side of the brain, which gives him a slightly better chance of recovery than if it were on the left side. In 90 percent of the population, the left side of the brain is the speech and language headquarters.

Speech or language disorders occur in up to 40 percent of stroke patients, according to the Columbia University Complete Home Medical Guide.

Dr. Kidwell said there are two types of strokes — hemorrhagic and ischemic — and noted that Mr. Sharon recently underwent each type. He had a minor ischemic stroke, which involves a blockage of a blood vessel to the brain, on Dec. 17 and was given blood thinners to treat it.

Yesterday, Dr. Kidwell and other medical experts said those blood thinners could have been a factor in the severity of the prime minister’s second stroke.

Blood thinners “can cause increased risk” of strokes, she said.

No one yesterday was saying the blood thinner, enoxaparin, caused a blood vessel in Mr. Sharon’s brain to burst. They agreed the drug was appropriate therapy for his first stroke. But they acknowledged that the blood thinner probably made his bleeding more severe.

Asked whether age and obesity are risk factors in Mr. Sharon’s recovery, Dr. Kidwell said, “Weight may be a risk factor for ischemic strokes,” and the risk of strokes “increases as we get older.”

“Younger patients recover faster and better” from strokes than the elderly, Dr. Kidwell said.