Hayden testing continues today executive is alert and in good spirits

May 11, 1994|By Larry Carson | Larry Carson,Sun Staff Writer Sun staff writer Scott Shane contributed to this article.

Baltimore County Executive Roger B. Hayden is to remain a patient at Johns Hopkins Hospital at least through today while he undergoes tests to determine more about the effects of the ruptured blood vessel in his head.

Mr. Hayden lost much of his right-side vision from both eyes after the incident Sunday, although Dr. Kyra Becker, a Hopkins intensive care neurologist who initially treated the county executive, said his vision may improve in time.

Baltimore County Communications Director Robert Hughes said he spoke with Mr. Hayden yesterday and found him alert and in good spirits. The county executive's condition is not life-threatening, hospital officials said.

The executive is out of intensive care, and now being treated by Dr. John Weingart. His police bodyguards are assisting him at the hospital, Mr. Hughes said.

An angiogram was administered to Mr. Hayden yesterday. Hopkins spokesman Mark Kusinitz said the test takes two hours, and the patient must lie still for six hours afterward to avoid disturbing the dye that has been injected into his blood. Today, Mr. Hayden is to undergo a magnetic resonance imaging test, a computer enhanced, color-coded picture of tissue that uses a magnetic field instead of radiation.

It was unclear yesterday how long Mr. Hayden will have to remain hospitalized, or how long it will take to evaluate the various test results. The executive also had a CT scan performed on his head Sunday at St. Joseph Hospital in Towson before he was transferred to Johns Hopkins.

The 49-year old county executive awoke Sunday morning at his home with severe head pain. Speaking Monday from his hospital bed, Mr. Hayden said the problem was due to a condition called a vascular malformation diagnosed years ago.

He said he has had periodic headaches but never had a blood vessel break before.

Dr. Becker said Mr. Hayden lacks capillaries between the arteries and veins in the occipital lobe in the back of his head. She said blood thus moves through these abnormal blood connections more quickly than normal, creating higher pressure.

Over time, the specialist said, the vessels can grow and occasionally rupture, as Mr. Hayden's did.

Dr. Becker said it is difficult to forecast whether Mr. Hayden will experience further difficulty with the condition. It is also impossible to predict how much vision he might recover, she said, although some vision recovery is likely as the blood dissipates internally. Medical problems resulting from vascular malformations in the brain are "pretty rare," said Dr. Thomas R. Price, professor of neurology and head of the stroke program at the University of Maryland. "We probably see seven or eight cases a year here," he said.

Though present from birth, such areas of weak blood vessels often rupture in mid-life, said Dr. Greg Albers, director of the stroke center at Stanford University. "It takes that long for the vessel walls to grow weak enough to rupture," he said.

Loss of right-side vision means that the bleeding damaged part of the left hemisphere of the brain, the neurologists said.

"The brain is nearly the consistency of Jello, so bleeding can actually cut through it," Dr. Price said. If the bleeding merely puts pressure on brain tissue, it can recover; if it destroys tissue, the damage can be permanent, he said.

Vascular malformations can be treated with surgery to remove part or all of the vessels involved, with radiation to seal up vessels, or with an injection of a kind of medical "glue" through a catheter to close off vessels, the doctors said.

A patient's chances for recovery of lost vision varies greatly, depending on the type of malformation, its size and its location in the brain. But when vision loss on one side is permanent, the brain often makes adjustments to reduce the resulting disability.

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