Michael Schumacher, a record-setting Formula One driver who retired in 2012, is no longer in a coma, a family spokesperson announced Monday. Schumacher had been in a medically induced coma since a skiing accident in late December left him with severe head injuries.
The family has released few details about Schumacher’s condition, so it’s difficult to know what his prognosis will be. But from what we know about his injuries and his medical care so far, it’s safe to say that his rehabilitation process will be long and arduous.
Schumacher’s Path So Far
Even when he was first airlifted to Grenoble University Hospital Center, the head of his medical team told reporters that it was impossible to predict how successful treatment would be; at that time, he was “fighting for his life.”
The lesions on one side of Schumacher’s head were so severe that if he hadn’t been wearing a helmet, “he wouldn’t be here,” his doctor said. (The helmet split in half on impact.)
Schumacher was conscious after his injury, The New York Times reported, but doctors put him into a coma, a common strategy when someone has experienced major head trauma. “Shutting down function can give the brain time to heal without the body performing radical triage by shutting off blood flow to damaged sections,” writes David Biello in Scientific American.
A medically-induced coma is very different from a “natural” coma, largely because it is reversible. Doctors induce a coma to reduce swelling and inflammation and increase the chances of rehabilitation and recovery. They use the same drugs used for anesthesia — “it’s just a difference in dosage,” explains anesthesiologist Emery Brown of Harvard.
After surgeons performed initial emergency operations on Schumacher, drilling into his skull to relieve pressure and remove blood clots, they discovered that there were still “extensive blood clots in his brain that were inaccessible to further surgery,” according to a New York Times report in January. Such clots often create “a major risk of lasting impairment.”
Further details about Schumacher’s state were not released, and experts told The Times that “full recovery,” “long-term impairment,” and even death were all possibilities.
In February, doctors began the slow process of trying to bring Schumacher out of the coma, to see whether he would be responsive — or in a vegetative state. Someone does not “wake up” as soon as the sedatives used to induce the coma are stopped, as the powerful drugs can take a while to clear the body.
“A couple of weeks after you stop sedatives it’s too early to say that somebody is in a persistent vegetative state,” David K. Menon, a Cambridge University anesthesia told The Times. “But the more time you take to wake up, the less the probability that you’ll have the sort of recovery you’d hope for.”
In April, there was finally what seemed like some good news: “Michael is making progress,” a family statement said. “He shows moments of consciousness and awakening.” At that time, experts said the possibility of “substantial recovery” was possible, but not certain.
So what comes next for Schumacher, now that he has left Grenoble?
The Times pointed to the case of another athlete who sustained serious head trauma, “Michael Watson, a boxer who suffered near-fatal brain injuries in a London bout in 1991.” Watson “spent months in a coma — and years learning to walk again and recover other basic living skills.” The case, The Times noted, is an oft-cited example of “how sportsmen can make substantial recoveries, with years of rehabilitation, from grievous brain injuries.”
Schumacher’s next steps may look similar.
A German tabloid reported that Schumacher could “hear voices and respond to touches,” but those reports were unconfirmed.
The family spokesperson said that Schumacher will “continue his long phase of rehabilitation.” He is being transferred from the French hospital, near the ski resort where he was hurt, to a Swiss hospital closer to his home, the Associated Press reported.
The Associated Press also spoke to a neurosurgeon, who gave a reasonable account about what could come next for Schumacher — although since the family has been mum on details, his actual prognosis could be quite different:
“If he’s been released from the hospital he was in, it means he’s able to support his own breathing and bodily functions,” said Dr. Tipu Aziz, a professor of neurosurgery at Oxford University’s John Radcliffe Hospital.
The fact that Schumacher is going into rehabilitation “suggests there’s been long-term side effects of his injury,” he added.
“With rehabilitation, they will try to train him to cope with the disabilities that he’s got to achieve as much life function as possible,” Aziz said. “If he’s had a brain injury, he may have weakness in his limbs secondary to loss of brain function. He may have problems with speech and swallowing.”
He said that “rehabilitation would probably take a good few months” but noted that Schumacher was an athlete before his accident “so was in good shape.”
The spokesperson reaffirmed the family’s previous requests for privacy, noting that Schumacher’s “further rehabilitation will take place out of the public eye.”
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