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March 22, 2005

CSI MedBlogs: CodeBlueBlog Analyzes Terri Schiavo's CT Of The Brain

Topics: Terri Schiavo's Life Counts

THIS BRAIN IS NOT THAT BAD according to award-winning medical weblog "CodeBlueBlog."

From CodeBlueBlog comes some important and very interesting comments:

Thanks to reader "primer" I've been directed to the University of Miami Ethics program website where they posted this image from a CT scan of Terri Schiavo's brain in 1996. The sentence attached to the link for this scan on the site says:

HERE is the CT scan of Ms. Schiavo's brain, showing extensive cortical regions filled with spinal fluid.

A COURT OF MEDICAL LIGHTWEIGHTS WEIGH IN ON TERRI'S CT.

The Second District's first opinion in this case explained:

Since 1990, Theresa has lived in nursing homes with constant care. She is fed and hydrated by tubes. The staff changes her diapers regularly. She has had numerous health problems, but none have been life threatening.

Over the span of this last decade, Theresa's brain has deteriorated because of the lack of oxygen it suffered at the time of the heart attack. By mid 1996, the CAT scans of her brain showed a severely abnormal structure. At this point, much of her cerebral cortex is simply gone and has been replaced by cerebral spinal fluid. Medicine cannot cure this condition. Unless an act of God, a true miracle, were to recreate her brain, Theresa will always remain in an unconscious, reflexive state, totally dependent upon others to feed her and care for her most private needs.

(...) First, I contest the theory that Terri's brain actively continues to degenerate as implied by the above statement. How could they gage serial brain degeneration without serial follow-up? And by what mechanism would her brain CONTINUE to atrophy? Second, Terri's cerebral cortex has not been replaced by fluid. That is inaccurate. The cortex is thinned and the sulci are enlarged. There is a difference.

(...) Third, and most importantly, given the amount of atrophy on this image I disagree with the court's inadequately considered conclusion.

(...) First of all, the University of Miami's appellation for this scan is inaccurate. "Cortical regions" are not and can not be filled with spinal fluid. The sulci (spaces between cortical ribbons) are enlarged secondary to cortical atrophy and these sulci are filled with cerbrospinal fluid.

(...) The most alarming thing about this image, however, is that there certainly is cortex left. Granted, it is severely thinned, especially for Terri's age, but I would be nonplussed if you told me that this was a 75 year old female who was somewhat senile but fully functional, and I defy a radiologist anywhere to contest that.

(...) I HAVE SEEN MANY WALKING, TALKING, FAIRLY COHERENT PEOPLE WITH WORSE CEREBRAL/CORTICAL ATROPHY. THEREFORE, THIS IS IN NO WAY PRIMA FACIE EVIDENCE THAT TERRI SCHIAVO'S MENTAL ABILITIES OR/OR CAPABILITIES ARE COMPLETELY ERADICATED. I CANNOT BELIEVE SUCH TESTIMONY HAS BEEN GIVEN ON THE BASIS OF THIS SCAN.

(...) The worrisome, no alarming thing, for me, was that I heard a bioethicist and several important figures on the major media describe Terri's brain as MUCH WORSE. One "expert" said that she had a "bag of water" in her head. Several experts described her as a "brain stem preparation"

Continue reading the entire post .....

UPDATE: DO NOT FAIL TO READ THE COMMENTS AT CODEBLUEBLOG!

Cross posted at BlogsForTerri

Posted by Hyscience at March 22, 2005 10:26 PM

I know through finding out more and more about Terri, and through comparisons of other CTs that I am positive that Terri has what's called an Arachnoid Cyst.

Arachnoid cysts are cerebrospinal fluid-filled sacs that may develop between the surface of the brain and the cranial base or on the arachnoid membrane - one of the 3 membranes that cover the brain and the spinal cord. Most cases begin during infancy, however onset may be delayed until adolescence. Symptoms of an arachnoid cyst are related to the cyst size and location. Small cysts are usually asymptomatic and are discovered only incidentally. Large cysts may cause cranial deformation or macrocephaly (enlargement of the head), producing such symptoms as headaches, seizures, hydrocephalus (excessive accumulation of cerebrospinal fluid), increased intracranial pressure, developmental delay, and behavioral changes. Other symptoms may include hemiparesis (weakness or paralysis on one side of the body) and ataxia (lack of muscle control).

Untreated, arachnoid cysts may cause permanent severe neurological damage due to the progressive expansion of the cyst(s)or hemorrhage (bleeding). With treatment most individuals with arachnoid cysts do well.

I am sorry they misdiagnosed her. Terribly sorry. I just found out about her and it kills me knowing she has gone through a full decade of neglect.

Posted by: Barbara at March 25, 2005 10:25 PM



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