Posted on 01/05/2006 1:40:42 PM PST by NormsRevenge
LONDON - The blood thinner may be to blame for the severity of Israeli Prime Minister Ariel Sharon's stroke, but his doctors should not be criticized for prescribing it, independent experts said Thursday.
Sharon was fighting for his life in an Israeli hospital after seven hours of surgery to remove blood from the right side of his brain following a burst blood vessel, or hemorrhagic stroke. His doctors said they planned to keep him sedated for another 72 hours. Experts say his chances of recovery are slim.
Experts agree that while the blood thinner, an anticoagulant called enoxaparin, did not cause the blood vessel in Sharon's head to burst, the bleeding would probably not have been so severe if he had not been taking the medication.
The 77-year-old premier was given the blood thinner after a minor stroke Dec. 17 after a blood clot traveled from his heart to his brain. That stroke led to the discovery of a small hole in his heart, a birth defect. Doctors had prescribed the blood medication to prevent another clot-related stroke before the hole in his heart could be repaired.
Dr. Shlomo Mor-Yosef, director general of Hadassah Hospital, defended Sharon's treatment with blood thinners, saying Thursday he was given appropriate doses.
"The doctors were responding to that first stroke properly with the use of blood thinners," said Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at New York University. "That comes with a price. The price is the increased risk of brain hemorrhage, which is what happened in this case. They shouldn't be criticized because it has not been proven what is the best choice of treatment for patients with these holes in their heart."
There are two types of stroke. Most of them — about 85 percent — are caused by blood clots traveling to the brain. The others are caused by a ruptured blood vessel in the head.
Blood thinners are commonly given after clot-related strokes. They reduce the risk of another clot-related stroke but at the same time raise the risk of bleeding.
Giving Sharon a blood thinner was a tough judgment call, but one that many of the best doctors would have made, Siller said.
"If they hadn't given him blood thinners and he had another clot-related stroke — which could have happened — there would have been outrage and criticism that the doctors had not treated the first stroke aggressively enough," said Siller, who is leading a study on whether medication or closure of a hole in the heart is the best way to prevent strokes.
Whatever the role of the blood thinners, experts said Sharon's chance of recovery were slim.
The fact the stroke happened in the right side of the brain indicates a slightly better chance of recovery than a left-brain stroke, experts say. But Sharon is unlikely to emerge unscathed, even if he makes it through the next critical days.
In 90 percent of people, the left side of the brain houses the speech and language center. Strokes on that side have a poorer prognosis.
A massive right brain hemorrhagic stroke means Sharon will certainly be left with permanent paralysis down the left side of the body, Siller said, along with visual and other impairments.
Patients who recover from these types of strokes also are often unaware of their paralysis. They may think they can get out of bed, or they may not even recognize their left arm as their own, Siller said.
"That would be someone who had made a good recovery. This man is still very much in danger of expiring. He's prone now to a heart attack and a million other things that could kill him even if this starts to get better.
"There will not be a full recovery, no matter which side of the brain the stroke was on," Siller said. "Success will be that he even wakes up ... that he regains enough functions just to leave the hospital and receive care at home or go to a nursing home."
Sharon's doctors said Thursday his pupils had responded to stimulation — proof that he is not brain-dead. However, it is too early to tell whether he will recover further than that.
Doctors will not be able to determine the extent of brain impairment until Sharon has been taken off the sedatives.
enoxaparin aka Lovenox
http://www.lovenox.com/consumer/homeAction.do
fyi
LOVENOX® (enoxaparin sodium injection) is a unique chemical entity in a class of antithrombotic agents known as low-molecular-weight heparins (LMWH). LOVENOX® was approved in the United States and Canada in 1993, and it has been available in Europe since 1987. LOVENOX® is the only low-molecular-weight heparin in the United States approved by the Food and Drug Administration in 7 approved indications for the prophylaxis and treatment of thromboembolic disease.
The #1 selling low-molecular-weight heparin in the world, the safety and efficacy of LOVENOX® has been demonstrated for more than 15 years treating over 100 million patients in 96 countries.
That can't be right. Pat Robertson says it was God that struck him down.
Sharon's setback was not caused by bloodthinners, but by too much of Twinkies and corned beef; and too little of walking, swimming and tennis.
He obviously didn't follow the Clinton diet as closely as he should have.
That is getting heavy discussion over here....of course the MSM has spun his comments somewhat:
The blood thinners pushed him over the edge.
Well, the truth be told, if he dies, God did have a hand it, regardless of what Robertson had to say.
"Well, the truth be told, if he dies, God did have a hand it, regardless of what Robertson had to say."
I see. Well, OK, then. Real good, then.
You can go back to DU now pal. Your so called beliefs are not mine. End of conversation.
Unfortunately... from the reports coming out, it seems it's just a matter of time.
"You can go back to DU now pal. Your so called beliefs are not mine. End of conversation."
Never been to DU. Never plan to. This is the USA. We have the freedom here to believe as we wish. I'm behind that freedom all the way. Are you?
Yes, the latest post on his condition is very negative. I hope that if it's his time it's a peaceful ending.
If you are what you say you are, then your beliefs differ from mine. You can toss out the old USA thing just like a liberal. Your site says conservatives are like you. I don't know any. Never met any. So, you must be the only one that says you are.
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