Text 10699, 57 rader
Skriven 2005-03-31 00:16:06 av EARL CROASMUN (1:275/311)
     Kommentar till en text av VERN HUMPHREY
Ärende: Bo Gritz
================
-> EC>There are some things that modern medicine can be fairly sure of.  One
-> EC>is that brain functions cannot be performed by dead, atrophied tissue.
-> EC>The reports I have read indicate that patients in a PVS typically have
-> EC>very low EEGs, in the range of five percent of normal.  Hers is zero.
-> EC>Flat.  None.

-> She has a FLAT EEG?  I don't think so.

"Terri was in a coma for approximately one month, and then evolved into
a vegetative state. Four board-certified neurologists in Florida
consulting on her care (James H. Barnhill, Garcia J. Desousa, Thomas H.
Harrison, and Jeffrey M. Karp) had repeatedly made a diagnosis of PVS
over the years. The initial CT scan on the day of admission, February
25, 1990, was normal but further CT scans documented a progression of
widespread cerebral hemisphere atrophy, eventually resulting in CT scans
of 1996 and 2002 showing extreme atrophy (CT scans-1996, 2002: diffuse
encephalomalacia and infarction consistent with anoxia, hydrocephalus ex
vacuo, neural stimulator present); prior to these most recent two CT
scans, CT scans had been performed on February 25, 1990, February 27,
1990, and March 30, 1990, with an MRI scan on July 24, 1990.The two most
recent EEGs have demonstrated no electrical activity-on July 8, 2002: no
evidence of cerebral activity; and October 4, 2002-does not have any
definite brain activity. However, most of the tracing is obscured by
artifact from muscle and eye movement. The clinical exams over the years
were entirely consistent with diagnosis of permanent vegetative state
secondary to hypoxic-ischemic encephalopathy. From the initial
hospitalization in February, 1990, until the present time, there have
been no significant changes in Terris neurological findings, and nothing
in the medical records to suggest any disagreement whatsoever among
Terris attending and consulting physicians about the underlying
diagnosis and prognosis for recovery."
 - Dr. Ronald Cranford, one of the neurologists who actually examined
her


"On February 25, 1990, Terri Schiavo had a cardiac arrest, triggered by
extreme hypokalemia brought on by an eating disorder. As a result,
severe hypoxicischemic encephalopathy developed, and during the
subsequent months, she exhibited no evidence of higher cortical
function. Computed tomographic scans of her brain eventually showed
severe atrophy of her cerebral hemispheres, and her
electroencephalograms have been flat, indicating no functional activity
of the cerebral cortex. Her neurologic examinations have been indicative
of a persistent vegetative state, which includes periods of wakefulness
alternating with sleep, some reflexive responses to light and noise, and
some basic gag and swallowing responses, but no signs of emotion,
willful activity, or cognition.

There is no evidence that Ms. Schiavo is suffering, since the usual
definition of this term requires conscious awareness that is impossible
in the absence of cortical activity."

 - article in the latest issue of the New England Journal of Medicine


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