First off, this press conference was rather more reassuring than what I expected. I’ll admit that I feared an announcement of a second operation for persistently elevated intracranial pressure (ICP), and the fact that that’s not been needed is good.
So what do we know now? We know that besides keeping Michael deeply asleep, they’ve also slightly lowered his body temperature. This is part of the strategy to optimise the brain’s metabolic state. Along with increasing the delivery of “good stuff” to the brain, reducing the temperature reduces the brain’s need for stuff. Therefore the supply:consumption relation is rendered more favorable.
We’ve’ been told that Michael has bilateral lesions. This mean the brain is wounded in both hemispheres. That shouldn’t surprise us. This was a hard hit. What kind of “lesions”? While we haven’t been told exactly, we can assume a mix of three types. First, the hematoma itself. This is a collection of blood that can be evacuated. That’s been done, and Michael will be examined and scanned regularly in order to detect the formation of any new hematomas, or re-accumulation of the original one.
Next are contusions. These are basically black-and-blue marks in the brain. They result from blunt forces, and consist of areas of swelling and blood that’s seeped out of the vessels into the tissues – just like when you hit your arm. In the brain, as elsewhere, that blood gets absorbed, and the damage heals. Usually fine, but sometimes leaving small cavities behind.
The third type of lesions are at the microscopic level. They consist of damage to the bundles of “cables” (axons) connecting groups of brain cells. This type of damage isn’t readily visible using standard imaging, but is often associated with “poor neurological outcome”. These lesions aren’t treated specifically; rather, they are managed by classic neuro intensive care principles – maximise brain happiness and avoid brain unhappiness.
Hope this helps!