Michael Schumacher in critical condition after head trauma

I read the following interview on the website of the German news channel N24. It gives some insight on the current situation and possible next steps. The interview partner is Prof. Dr. Peter Vajkoczy, the head of neurosurgery on the renowned Charit? hospital in Berlin. I already saw him in interviews on N24 a few times before, he seems to be a very level headed, honest and knowledable expert.


Mr. Vajkoczy, what is the purpose of the tests which are currently performed?
Vajkoczy: The doctors performed a computer tomography (CT) to see how bleedings and swellings in the cranium have developed. But because the CT has low resolution, it only gives a rough insight and some measurement data on cranial pressure. Nonetheless, the CT is good enough to judge whether he can be taken out of coma. Seemingly this is not the case yet.

What are further possible examinations?
Vajkoczy: Next step would be magnetic resonance tomography (MRT). But seemingly Mr. Schumacher is not stable enough to be transported into the MRT. On the way there he would need artificial respiration, and the transport seems to be too complex at this time.

What findings could doctors gain with an MRT?
Vajkoczy: An MRT is better than a CT because it provides a more detailed insight whether nerve tracts and the functionally relevant areas [of the brain] are ok. They can see what the brain stem looks like and get information on whether Michael Schumacher will be able to wake up properly.

Are there other ways to check if nerve tracts are damaged?
Vajkoczy: Yes, they could perform an electrophysiology. They would stimulate certain brain areas and see if there is a signal in the peripherals or whether the nervous system transports the signals. For example, the doctors can check whether the arm twitches when stimulated [in the brain]. If this is the case, they can conclude that the nervous system is okay. If there is no twitching, they know there must be an injury in this tract.

Mr. Schumacher has been in artificial coma for 17 days. From a medical point of view, is this a normal period of time or reason for worrying?
Vajkoczy: It's normal to leave patients in this state for three or four weeks. The duration of the artificial coma is no basis for a prediction and also contains no information on future developments. It is however an indication that Michael Schumacher suffered a severe head trauma and brain swellings and the cranial pressure is still too high. As long as this pressure is not under control, the doctors will keep Schumacher in artificial coma as long as necessary.

In your opinion, when will the doctors be able to discontinue the sedatives and start the wake-up phase?
Prof. Vajkoczy: The doctors will of course not inform the plublic about the start of the wake-up phase. After stopping the supply of sedatives, it will take three or four days [until Schumacher is fully out of coma]. From then on, the clock would be ticking and they would get first signs of how his condition develops. This risk still seems too high. As soon as they take him out of coma, the cranial pressure may rise again and there may be complications. They simply don't know what happens when they turn a little screw and initiate wake-up of the patient. Last week they said that the cranial pressure is stable and that they can consider staring the wake-up phase. Because this has not happened yet, there must be a reason to keep Schumacher in coma. There probably still are swellings and other problems which the doctors are not in control of yet.

Does the duration of the coma indicate permanent brain damage?
Vajkoczy: A prediction about the recovery of Schumacher is still not possible, there still are dangers of complications like an infection. Only an MRT would be able to provide a thorough prediction. Then they would be able to see injuries which appear after an artificial coma. This does not mean that Mr. Schumacher couldn't recover from those as well in rehab. There could be dysfunctions in talking, motor skills or retentivity.
 
Redliner said:
I read the same.

Hope it's just the media trying to keep in on the news, otherwise it would be terrible. :(
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Yeah. Every day I see a clickable headline that declares BREAKING NEWS SCHUMI STILL IN COMA and there's nothing else than speculations by someone who isn't directly involved with his treatment.
 
DubyaStep said:
Seeing as the coma is the treatment and that it was medically induced, I'm betting he will wake when the time comes. There is, however, no telling who he will be mentally.
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argatoga said:
No offense, but until I hear from a doctor or the family I'm not putting faith into what the press says.
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The interview was with a brain injury specialist, and even though he commented on Schumacher it wasn't specifically facts about his case.

Michael Schumacher will have to adjust to being a very different person, brain injury specialist warns
Dr Richard Greenwood says at launch of study into traumatic head injuries that 'if Michael Schumacher survives, he will not be Michael Schumacher - he will be Joe Bloggs'
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public said:
Yeah. Every day I see a clickable headline that declares BREAKING NEWS SCHUMI STILL IN COMA and there's nothing else than speculations by someone who isn't directly involved with his treatment.
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The media finds itself in a very difficult situation: everybody wants to hear news, but there isn't the tiniest snippet to report about.
 
he-he said:
The interview was with a brain injury specialist, and even though he commented on Schumacher it wasn't specifically facts about his case.
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Every case is different. In my case I have some minor cognitive issues among other things. I have seen people with my same injuries who can't talk. There is no news because the just won't know untill he is awake who he will be.
 
He's coming back, he'll wake up rested and fresh. I never doubt him and I never will. :)
 
Guys, keep your hopes high but realize this isn't anything other than the planned removal of the medically induced coma. It does not mean he hasn't sustained a serious, lasting intracranial injury. It's what he does in the coming hours to days that will tell us how he's likely to do.
 
True, it may take months or even years to see if he'll ever be anywhere close to who he was before. But, you have to start somewhere. :)
 
I will grasp to the notion that the doctors think he is well enough to even attempt this.
 
Any news on this matter? Did he wake up? What's going on? I heard nothing for like 3 weeks now...
 
He's still in the wake-up phase. You have to remember that this is not a classical post-op wake-up phase where they stop the sedative supply and you wake up within a few hours.

Schumi still is on sedatives to keep him in a comatose state, they're simply reducing the amount of sedatives in small steps. After each reduction they wait for a while and constantly check on him to see if his health changes for the worse. If he remains stable, they reduce the amount by another step. The whole process can easily take weeks.
 
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the Interceptor said:
He's still in the wake-up phase. You have to remember that this is not a classical post-op wake-up phase where they stop the sedative supply and you wake up within a few hours.

Schumi still is on sedatives to keep him in a comatose state, they're simply reducing the amount of sedatives in small steps. After each reduction they wait for a while and constantly check on him to see if his health changes for the worse. If he remains stable, they reduce the amount by another step. The whole process can easily take weeks.
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Ah, I see. Thanks for the explanation, still hoping for the best.
 
It doesn't look good. I wish it looked better.
 
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