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A man in Nebraska who doctor believed had experienced a devastatingstrokeactually had a dissimilar condition — as luck would have it , one that allowed him to come back from the brink of death .
After his kid accepted that their father was probable to perish and decide to have him removed from his breathing subway system , T. Scott Marr kept external respiration and start to move his fingers and toes , Nebraska ’s WKRN describe . Doctors soon recognise that Marr had not experienced a separatrix , as initially believed . Instead , he had a condition name later reversible encephalopathy syndrome , which postulate well up in the brain . [ 27 Oddest Medical Case Reports ]
" It ’s an combat injury that is going to get better when the intumescence goes down , as opposed to a stroke , which is an harm that may not retrieve in the same way , " said Dr. S. Andrew Josephson , a professor and electric chair of neurology at the University of California , San Francisco and a member of the American Neurological Association . Josephson was not call for with Marr ’s case .
A difficult diagnosis
consort to WKRN , Marr was chance unconscious on Dec. 12 . Doctors diagnosed him with a stroke and observedswelling in his brain . One of his Dr. at Methodist Hospital in Omaha , Nebraska , Dr. Rebecca Runge , told reporters that the aesculapian squad feared the legal injury was irreversible .
But after Marr ’s respiration pipe was removed and he began to respond to simple statement , doctors re - evaluated his diagnosis . He had n’t experienced a apoplexy , they found . Instead , he had posterior reversibleencephalopathysyndrome , or PRES .
In about 70 percent of cases , PRES is triggered by an extreme increase in roue pressing . Such a ear can damage the roadblock between the blood vessels and the brain tissue paper , causing leak and bulge , said Dr. Joseph Miller , a clinical associate professor at Wayne State University and an emergency - medicament doc at Henry Ford Hospital , both in Detroit . Miller was also not involved with Marr ’s case .
It ’s not surprising that PRES was mistaken for a stroke , Miller told Live Science . The symptom of PRES , which range fromheadacheand visual sense deepen all the way up to coma , are quite like to those of stroke , and stroke are far more common than PRES . At Henry Ford Hospital ’s emergency room , Miller say , there are only about eight confirmed cases of PRES each year , out of just about 450,000 ER visits .
PRES is also easy to drop on a CT scan , Miller enunciate . It ’s best diagnose withmagnetic vibrancy imaging(MRI ) . But in many hospitals , it can take hr or even a twenty-four hour period to get a patient role an MRI scan , so doctors might start handling for a cerebrovascular accident first .
A distinctive treatment for PRES involve remove the underlying cause , Miller and Josephson said . ( Marr and his medical squad did not expose the underlying reason of Marr ’s PRES . ) If the cause ishigh blood pressure sensation , for exercise , the patient ’s bloodline pressure should be bring down with medication .
Sometimes , PRES occurs in patient taking immunosuppressive drugs , perhaps because these medicines somehow interpose with the membrane within those patient ' stock vessels . In such guinea pig , Miller and Josephson say , the treatment is for the affected role to stop taking the particular medication .
“Nearly brain-dead”?
Marr and his family called the convalescence a " miracle . " Though newsworthiness paper called Marr " intimately mind - dead , " that ’s an inaccurate and perplexing use of the terminal figure , Josephson tell Live Science . mind deathis a very specific condition that is virtuously , ethically and lawfully indistinguishable to just manifest dying , he said . It affect irreversible mastermind scathe that intend the person can no longer breath on his or her own . hokey ventilation can crowd air into the somebody ’s lungs , making it look as if they are alive and external respiration , but without aesculapian machinery , breathe stops . [ The scientific discipline of Death : 10 Tales from the Crypt & Beyond ]
Brain death " has a very , very specific [ curing of ] criteria that have to be met , " Josephson said . There is no such thing as being nearly encephalon - stagnant , he said : You either are or you are n’t .
" This patient had a neurologic wound and was not doing well , and then [ he ] recovered from it , " Josephson pronounce . " I would be very loath to even introduce the term ' brain last . ' "
Marr was , however , very fortunate . While PRES is reversible , it is far from harmless .
" If untreated , it can certainly be fatal , " Miller said of the condition . " And even with treatment , there are casual fatality if it ’s caught too late . "
Originally published onLive scientific discipline .
