We just received this press release from San Francisco General Hospital and Trauma Center today on Bryan Stow’s medical condition. The upshot is in the first paragraph: “(H)e is showing significant improvement and his neurological exams are much better.”
“There have been lots of ups and downs for Bryan, which is not uncommon for patients with severe brain injury,” said Dr. Geoff Manley, Chief of Neurosurgery, who is leading Mr. Stow’s care team. “We are pleased to announce that he is showing significant improvement and his neurological exams are much better. His ability to follow commands and interact with family has increased greatly.”
Though Mr. Stow remains in serious condition, there have been several recent developments in his case that are illustrative of the complicated course of recovery for traumatic brain injury (TBI) patients. SFGH, the only trauma center in the city, specializes in care for brain and spinal cord injured patients. The complexities of TBI patient care often exceed the expertise of hospitals that do not specialize in this area of injury.
Mr. Stow arrived at SFGH from LAC+USC Medical Center on Monday May 16, after being severely injured in an assault on March 31 in Los Angeles, where he suffered traumatic brain injury. He underwent a decompressive craniectomy in Los Angeles, a life-saving surgical procedure to remove a piece of the skull to relieve pressure caused by brain swelling resulting from the beating.
Dr. Manley replaced the missing skull fragment on Wednesday, August 10 with a custom prosthetic bone flap. After several days of close observation and oversight, Mr. Stow appears to be tolerating the procedure well. This is the second attempt to replace the bone. In mid-July, Dr. Manley replaced the skull fragment for the first time, but in that instance fluid quickly collected and was trapped underneath the fragment, resulting in a rapid decline in his neurological status. Within an hour, Mr. Stow was rushed to the operating room to remove the bone piece. That set-back required several weeks of constant supervision and regular intervention to drain excess fluid, to prevent Mr. Stow from suffering further harm. We will continue to monitor him closely and will determine over the next week whether he will require a shunt to permanently divert this fluid.
“Bryan’s trajectory is his own, but it is not uncommon for TBI patients with this degree of severe brain injury to have significant ups and downs,” Dr. Manley said. “Though he still cannot speak, he is now able to move slightly upon command and to turn his body toward someone talking to him. We are buoyed by these developments, but we still do not know how far his recovery will take him.”
Mr. Stow is awake and breathing on his own. His anti-seizure medications have been reduced and he is now on a stable regiment to prevent further post-traumatic seizures. He is following simple commands and beginning to interact with his family. The goal now is to place him in a rehabilitation facility as soon as he no longer requires acute hospital care.
“For TBI patients, we must be vigilant,” Dr. Manley said. “Recovery is not a straight line, and each patient is incredibly complex. The ability to recognize, solve and treat these challenging problems is what our team brings to each of the 1,200 brain and spinal cord injured patients we care for each year. The public’s interest in Bryan allows us to explain more about this important health problem that affects so many and the importance of specialized care and centers of excellence in TBI.”