Sharon's doctors face new criticism

The prime minister lay comatose for an eighth day Thursday.
JERUSALEM (AP) -- Ariel Sharon's doctors faced new criticism Thursday for failing to divulge a brain disease discovered after the prime minister's initial stroke and for prescribing blood thinners that may have contributed to a massive second stroke.
The criticism added to a growing chorus of questions about Sharon's treatment. Some experts, however, said there was no clear-cut answer.
As Sharon lay comatose for an eighth day Thursday, a brain scan showed the remnants of the blood in his brain from a Jan. 4 stroke have been absorbed, hospital officials said in a statement.
In response, doctors removed a tube they had inserted into Sharon's skull to relieve pressure on his brain, the statement said.
What's next?
In coming days, doctors may have to cut a hole in Sharon's neck to assist breathing, while still waiting for the clearest sign of improvement: the moment he opens his eyes.
After Sharon, 77, suffered an initial, minor stroke Dec. 18, doctors put him on Clexane, an anticoagulant. At a news conference a few days later, doctors acknowledged blood thinners increased the risk of brain hem-orrhage, but said the fear of a clot leading to another stroke was greater in this case.
The debate gained momentum after the Haaretz daily revealed that Sharon also suffered from cerebral amyloid angiopathy, known as CAA, a disease common in the elderly that weakens the blood vessels in the brain and increases the risk of hemorrhage.
Doctors confirmed they knew about the disease after the first stroke, but prescribed the blood thinners anyway, a move outside experts criticized Thursday.
"If someone has a disease that caused bleeding, that causes bleeding, that could cause bleeding in the future, giving anticoagulants ... is certainly an undesirable situation," said Amos Korczyn, head of the Tel Aviv University Medical School's neurology department.
Debate over cause
Doctors were prescribing the Cloxane until they could seal a small hole in Sharon's heart they said caused Sharon's first stroke.
But some experts questioned that theory and said the initial stroke was more likely caused by Sharon's brain condition. Sharon suffered his massive stroke a day before he was to undergo the procedure to seal the hole in his heart.
"The likelihood is that the hole in the heart was of no relevance," said Dr. Anthony Rudd, a stroke specialist at London's St. Thomas' Hospital. He said CAA could have caused the first stroke.
Doctors did not disclose the condition in December, and several Israeli media outlets chided Sharon's medical team for keeping it under wraps.
Israel's Channel 10 TV quoted an anonymous medical official as saying that Sharon's advisers asked them not to divulge the CAA ahead of the March 28 election. Asaf Shariv, a top Sharon adviser, denied the report, saying he learned about the condition from the media. "I don't even know if the prime minister knew," Shariv said.
Dr. Rudd said he would not have prescribed Cloxane if he suspected CAA, and might have gone for a weaker drug, such as aspirin, or a lower dose of blood thinners.
Other doctors disagreed, saying each physician must weigh the risks based on their knowledge of medications and the patient's condition.
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