A shunt is a tube inserted into the brain to reduce pressure caused by build-up of cerebrospinal fluid (CSF) in the brain. These next two scans are to give the reader some idea of what a shunt looks like in a scan of the brain.

http://www.ispub.com/xml/journals/ijs/vol9n2/vp-fig1.jpg

http://www.jkns.or.kr/fulltext/Fig/0042001263f5.jpg

The thing that must be clarified from the beginning is Theresa Schiavo had an implant but it wasn't a shunt.

According to Michael Schiavo's November 19, 1993 deposition, case No. 90-2908-GD:
Q Okay. Tell me about Doctor Hosobuchi and his treatment of Terry?

A Well, the basic thing was we took her to California. He had some experimental stimulators that- he was placing in peoples' heads. There were some people that woke up. It's a whole protocol on it. I don't have it with me. But it would be very experimental. He put it in. He did some testing. There was no evidence of it working with Terry. The only thing it would do, when he turned it up passed a certain point Terry would just sit up, which was just motor response. She would just get real bright eyed because things were being stimulated. He wasn't thrilled about it because he didn't see any positive signs.

Q Was -- did he implant anything into her? Did he put anything in her head that remained?

A Yes.

Q Are they still?

A Yes.

Q What are they?

Page 26:

A Electrodes. They're platinum electrodes.
 

http://www6.miami.edu/ethics2/schiavo/2%20CTs.png

CT scans showing, left, a normal brain and, right, Ms. Schiavo's brain, giving evidence of extensive cortical regions filled with spinal fluid. The image on the right was made in 2002. The bright spot near the center is an intrathalmic stimulator placed in her brain in December 1990 in San Francisco, when her husband was seeking aggressive medical treatment.

According to Ken Goodman site http://www6.miami.edu/ethics2/schiavo/Schiavo_links.htm  , the above  brain scan with the shiny object belongs to Theresa "Terri" Schiavo.

I have to wonder at this point, why was the area around the scan blacked out? And WHY would one do that without first flipping the scan, to show that the shiny object is in fact on the left side?

This CT image is "flipped" (i.e. the CT scan is mirror-image backwards which is just an inconsequential error made when scanning the image into the computer), so the right side is LEFT and vice versa.

Thanks to reader "primer" I've been directed to the University of Miami Ethics program website where they posted this image from a CT scan of Terri Schiavo's brain in 1996. The sentence attached to the link for this scan on the site says:

CT scan of Ms. Schiavo's brain, showing extensive cortical regions filled with spinal fluid.
http://codeblueblog.blogs.com/codeblueblog/2005/03/csi_medblogs_co.html

DR. RONALD CRANFORD, UNIV. OF MN NEUROLOGIST: I'm extremely confident. I think at the time of the trial in 2002 there had been eight neurologists who examined her. And of those eight neurologists total, seven of them said beyond any doubt whatsoever Terri is in a vegetative state. Her CT scan shows severe atrophy or shrinkage of the brain. Her EEG is flat and there's absolutely no doubt that she's been in a permanent vegetative state ever since 1990. There's no doubt whatsoever, Dan. http://www.msnbc.msn.com/id/7328639/

I was cleaning my office the other night and came across a DVD my friend had sent to me awhile back. It was A&E's  documentary on the Terri Schiavo case. It was more than a little scratched up but I decided I would put it in  computer's DVD player and see what happen. It played perfect! As a result of listening, and an occasional glance toward the screen, I saw the above scan dated May 9, 1996. Being my daughter had been buried on May 9, 1993, that date sort of stuck out from my computer screen. Looking closer, I realized that the 'shiny' object ,that shows in the brain scans that Ken Goodman, and Ronald Cranford released to the public as being that of Terri Schiavo, could not be seen in this scan. And though the brain scan showed brain damage it did not appear to show the same degree of damage. Seeing this I decided to stop cleaning and watch the rest of the DVD.

The scan above was one of many scans on the DVD. All were labeled  as belonging to Theresa Schiavo 1996.

http://www.engadget.com/2007/08/02/deep-brain-electrical-stimulation-brings-man-out-of-vegetative-s/

While deep brain stimulation raises some issues in common with older bioethics, such as access to care, informed consent, and insurance coverage, this technology affects an entire brain circuit, bringing the risk of unforeseen consequences. Such effects could be either neurological or behavioral; neuroscience has not yet learned the full workings of even one complete circuit in the brain.
The Dana Foundation-Neuroethics http://www.dana.org/news/publications/detail.aspx?id=4222
 

READ MORE ON THE SUBJECT:

http://codeblueblog.blogs.com/codeblueblog/2005/03/csi_medblogs_co.html 

http://suebobsdiary.com/category/terri-schiavo/

thalamus (thăl'əməs) , mass of nerve cells centrally located in the brain just below the cerebrum and resembling a large egg in size and shape. The thalamus is a routing station for all incoming sensory impulses except those of smell, transmitting them to higher (cerebral) nerve centers. In addition, it connects various brain centers with others. Thus the thalamus is a major integrative complex, enabling sensory stimuli to evoke appropriate physical reactions as well as to affect emotions. With the hypothalamus, the thalamus establishes levels of sleep and wakefulness. It is also vital to the neural feedback system controlling brain wave rhythms.
http://www.answers.com/topic/thalamus?cat=health

right parietal bone

http://www.hawaii.edu/medicine/pediatrics/pemxray/v5c09.html
 

The subgaleal shunt has been and is currently used for the temporary bypass of the normal cerebrospinal fluid (CSF) pathways. We retrospectively reviewed all subgaleal shunts placed at the Children's Hospital, Birmingham, Ala., USA, from 1993 to the present and examined the life expectancy of revisions of this temporary method of CSF diversion. The average length of survival of primary, secondary and tertiary subgaleal shunts in this population was 37.4, 32.4 and 19.6 days, respectively. This current review demonstrates that the majority of patients in whom a subgaleal shunt is utilized may continue to obtain therapeutic diversion of their CSF for greater than 2.5 months with intermittent subgaleal shunt revisions. In the majority of cases, this length of time is sufficient to manage and resolve issues that would make ventriculoperitoneal shunting undesirable.

Copyright © 2003 S. Karger AG, Basel

http://www6.miami.edu/ethics2/schiavo/pdf_files/061505-autopsy.pdf

A 9 centimeter long implanted neurological thalamic stimulator wire extended outward from the right parietal bone and it was surrounded by a 1 centimeter bony nodule on the inner  table. This wire was traced and its tip terminated in the right thalamus. [Stephen J. Nelson, M.D.]

The "Implanted electrical stimulator" was found during the autopsy. [page 2]

In the left chest wall an implanted medical device with a wire extending through subcutaneous tissues of the left neck and into the left scalp. A flat, four-prong electrical device is in the subgaleal area of the left scalp. A wire then further extends into the cranial cavity. [Jon R. Thogmartin, M.D. PAGE 3]

Schiavo Implant Potentially Dangerous

by Janice Sanford

When a reporter did an article in the St. Petersburg Times, Feb 17,1991. pg.3, about Terri's surgery in which Yoshio Hosobuchi of the University of California at San Francisco in December(1990) implanted a neurological thalamic stimulator in her brain, they reported:

"The brain stimulator implant was a success, said her husband, Mike. Mrs. Schiavo is slowly emerging from the coma at the Mediplex Medical Center, a neurological care center in Bradenton, he said. She will undergo at least a year of speech, occupational and physical therapy."

Schiavo: She spent three months there. Then, while she was there, we heard of this doctor in California here that was doing experimental surgery, implanting stimulators in people's brains in hopes to stimulate any activity.

Now, we were told with this, too (Ph) when this doctor looked at the CAT scans, that it was probably not going to work Because there's just no brain left. But I did it anyway, because I loved Terri. And I wanted to bring my wife back. I wanted to have my wife back in me.

So I flew her out to California by myself, with a nurse. And I spent a month there. They inserted the stimulator.

KING: Didn't work?

SCHIAVO: No, it eventually didn't work, no. The protocol for the stimulator was three months. I kept it on her for a year. http://transcripts.com/TRANSCRIPTS/0310/27/lkl.00.html 

From Medical Examiner Jon R. Thogmartin autopsy report on Theresa Schiavo:

...In the left chest wall is an implanted medical device with a wire extending through subcutaneous tissues of the left neck and into the left scalp. A flat, four-prong electrical device is in the subgaleal area of the left scalp. A wire then further extends into the cranial cavity... http://news.findlaw.com/hdocs/docs/schiavo/61305autopsyrpt.pdf

Note: subgaleal area, is the area above the skull or within the scalp layer of the head; ...

Stephen J. Nelson,M.D. (Page 1, last paragraph) Neuropathology Gross Description:

...A 9 centimeter long implanted neurological thalamic stimulator wire extended outward from the right parietal bone and it was surrounded by a 1 centimeter bony nodule on the inner table. This wire was traced and its tip terminated in the right thalamus... http://news.findlaw.com/hdocs/docs/schiavo/61305autopsyrpt.pdf 

9 centimeters = 3.54 inches
OR
____________________
9 centimeters = the length of the (above) line

Question:

Forget about comparing brains for a minute. Where's all the wire and stuff that Dr. Nelson and Medical Examiner Jon R. Thogmartin are describing in their report? ) Chronic deep brain stimulation in its present US FDA - approved manifestation is a patient - controlled treatment for tremor that consists of a multi-electrode lead implanted into the ventro intermediate nucleus of the thalamus.

The lead is connected to a pulse generator that is surgically implanted under the skin in the upper chest.

And an extension wire from the electrode lead is threaded from the scalp area under the skin to the chest where it is connected to the pulse generator. Most users turn the unit off at night. The stimulus parameters can be adjusted to provide the best response and minimize adverse reactions.

The pulse generator must be replaced to change batteries, which should last five years.

Risks of DBS ( Deep Brain Stimulation) surgery are intracranial bleeding, infection, and loss of function. http://www/pallidotomy.com/deep_brain_stimulation.html 

Dr. Nelson seemed to think it was necessary to put in Terri's autopsy report a reason why she "had not undergone an MRI scan of her brain, rather than only a brain scan while alive":

"The FDA has received several reports of serious injury, including coma and permanent neurological impairment, in patients with implanted neurological stimulators who underwent magnetic resonance imaging (MRI) procedures. The mechanism for these adverse events is likely to involve heating of the electrodes at the end of the leadwires, resulting in injury to the surrounding tissue. Although these reports involved deep brain stimulators and vagus nerve stimulators, similar injuries could be caused by any type of implanted neurological stimulator, such as spinal cord stimulators, peripheral nerve stimulators, and neuromuscular stimulators". http://www.fda.gov/cdrh/safety/neurostim.html 

One would assume from the autopsy, that an MRI is never done on a patient with an implanted neurological stimulator.

The following is taking from the same report Dr. Nelson quoted from: If an MRI procedure is to be performed on a patient with an implanted neurological stimulator, be sure to review the labeling for the specific model that is implanted in the patient, with particular attention to warnings and precautions. The radiologist may need to consult with the implanting or monitoring physician for this information. Also note and follow any instructions exactly for MRI imaging that may be in the labeling for the implant, including information on types and/or strengths of MRI equipment that may have been tested for interaction with the particular implanted device. The radiologist may need to consult with the device implant manufacturer for this information. http://www.fda.gov/cdrh/safety/neurostim.html 

According to Michael Schiavo's November 19, 1993 deposition, case No. 90-2908-GD, page 24:

Q And what was the purpose of taking her to California?

A There was some experimental surgery that I heard about.

Q Do you remember the doctor you went to see out there?

A Doctor Yoshio Hosobuchi.

Page 25:

Q Okay. Tell me about Doctor Hosobuchi and his treatment of Terry?

A Well, the basic thing was we took her to California. He had some experimental stimulators that- he was placing in peoples' heads. There were some people that woke up. It's a whole protocol on it. I don't have it with me. But it would be very experimental. He put it in. He did some testing. There was no evidence of it working with Terry. The only thing it would do, when he turned it up passed a certain point Terry would just sit up, which was just motor response. She would just get real bright eyed because things were being stimulated. He wasn't thrilled about it because he didn't see any positive signs.

Q Was -- did he implant anything into her? Did he put anything in her head that remained?

A Yes.

Q Are they still?

A Yes.

Q What are they?

Page 26:

A Electrodes. They're platinum electrodes.

Q Did he suggest any future treatment that was experimental --

A Treatment for what?

Q -- in California. Diagnostic testing, anything of that nature?

A No. When Doctor Yingling was here, he came out and, basically, if it didn't work within --

Page 27:

Q My question was: Was there a suggestion of further diagnostic testing or procedures after the treatment by Doctor Hosobuchi in California?

A As far as I can remember -

Page 28:

Q Did Doctor Hosobuchi, after he saw Terry, recommend any further diagnostic procedures?

A He recommended that Doctor Yingling would be doing it.

Q So did she see Doctor Yingling?

A She -- Doctor Yingling came out here, I believe, a year later.

Q And that was at the suggestion of Doctor Hosobuchi?

A That, I have no idea.

Q Okay. What did Doctor Yingling say or do, to your knowledge?

A He came out -- Terry was at Mediplex -- he came out and did some testing, and he needed a CP-900 machine or something from Shands, and it wasn't available, and he said it wasn't no big deal. He told me he had -- he didn't see any evident sign that the stimulator was working, did some tests with Terry(i). Nothing was new with her from the time he had last

Page 29:

seen her. And that was basically it. We took him out to dinner and he had loads of wine and that was it. He spilled it all over our couch.

Q Other than the Doctor Hosobuchi and Doctor Yingling -- was Doctor Yingling also from California?

A Yes.

Q And he was somebody that Doctor Hosobuchi suggested see Terry?

A He was Hosobuchi's assistant.

Q Has she seen any other experts since that time?

A What type of experts?

Q Since Doctor Yingling saw her, what physicians have seen her?

Page 30:

Q Okay. When was the last time Terry had seen a neurologist?

Page 31:

A I'd have to look up some records. I don't remember.

Q. Has it been years?

A No, I don't think it's been years.

Q Has a neurologist seen her since Doctor Yingling saw her?

A I don't recall.

Q Have any diagnostic tests been performed since Doctor Yingling saw Terry?

Q Okay. of the neurology strain.

A I don't recall. There could have been. I don't recall.

According to Schiavo, "The protocol for the stimulator was three months" but he kept it on her for a year" even though he knew that leaving the stimulator on longer than three months could harm or even kill Terri.

Michael Schiavo should still be made to answer for abusing his wife after her brain injury.

Whether or not the implanted neurological stimulator worked, Michael Schiavo should have made sure that Terri had a neurologist following her case.

The implant had the potential to cause intracranial bleeding, infection, and loss of function.

 

This[above] CT image is "flipped" (i.e. the CT scan is mirror-image backwards which is just an inconsequential error made when scanning the image into the computer), so the right side is LEFT and vice versa. http://codeblueblog.blogs.com/codeblueblog/2005/03/csi_medblogs_co.html

This scan is from the DVD.

A 9 centimeter long implanted neurological thalamic stimulator wire extended outward from the right parietal bone and it was surrounded by a 1 centimeter bony nodule on the inner  table. This wire was traced and its tip terminated in the right thalamus. [Stephen J. Nelson, M.D.]

Other sites that have the brain scan from Goodman's site posted:

http://www.warriorsfortruth.com/terri-schiavo-brain-scan.html

http://www.amptoons.com/blog/archives/2005/03/18/terri-schiavo-news/

http://dererumnatura.us/archives/2005/03/schiavo-brain-s.html

http://www.courtroomblog.com/images/brain_damage__03_24_2005_Terry_Schiavo_004.jpg

KING: And you've made available for us a brain scan of her, right?

FELOS: Yes.

It appears that Michael Schiavo and his attorney George Felos released the scan on national television: http://transcripts.cnn.com/TRANSCRIPTS/0310/27/lkl.00.html  As did Dr. Ronald Cranford.

Why did Felos, Goodman, and Cranford pass an altered brain scan off as Theresa "Terri" Schiavo's???????

The fact is when the scan is turned the right way the shiny object is on the left. According to the autopsy "This wire was traced and its tip terminated in the right thalamus." [Stephen J. Nelson, M.D.]