It has been reported, but NOT by the hospital itself, that Jules is out of surgery and “breathing on his own”.

When a patient is brought emergently to the neurosurgical theatre for evacuation of a hematoma, the decision on how to manage the end of the surgery is a collaborative one, between the neurosurgeon, the anaesthetist, and perhaps the intensivist who will subsequently be charged with the patient’s care.

The decision basically involves: do we wake the patient up, or do we keep him or her asleep, intubated, ventilated mechanically, and do the wake-up later.

Factors that would tend to lead us to awaken after surgery would be:

relatively decent neuro status pre-op (meaning a GCS more like 8-10 or so)

a pre-op CT scan that doesn’t suggest widespread damage, intense swelling, or multiple hematomas (that kind of patient usually won’t make the preceding criteria, anyway)

a brain that doesn’t appear to swell when opened during surgery, and that doesn’t seem to have significant damage other than the hematoma

stable vitals and ICP during awakening

high quality surveillance and immediate availability of neurosurgical and anaesthetic resources

If indeed Jules is out of the OR, and if indeed he has been extubated and is breathing spontaneously by himself, then what is significant (in the absence of other specific medical information) is that this indicates how confident his surgeons and intensivists are that his neurological status is sufficiently stable to allow him that “luxury”. That would be really superb news.

#ForzaJules