Sharon Shows Slight Movement

Prime Minister Ariel Sharon breathed on his own and moved a hand and a leg as doctors on Monday began the arduous and delicate process of rousing him from the medically induced coma he had been in since suffering a massive stroke last week.

The 77-year-old Israeli leader remained unconscious and in critical condition, with physicians still unsure what degree of damage has been dealt to his cognitive abilities.

Still, the initial signs were read as hopeful ones, both by the team of Hadassah University Medical Center doctors and by Israelis anxiously awaiting the tiniest scrap of good news about their stricken prime minister.

Hemorrhagic strokes like the one suffered by Sharon on Wednesday, involving a burst blood vessel in the brain, are often fatal, sometimes weeks after the fact.

Sharon’s age and weight -- he is thought to be over 300 pounds -- add to the risk, as does the possibility of infection, to which many such patients succumb.

“We cannot say he is out of danger,” said Dr. Felix Umansky, who led the team that performed more than 12 hours’ worth of surgeries last week to stop bleeding in the prime minister’s brain.

Almost no one, either in Sharon’s inner circle of aides or among his doctors, believes he will be able to resume his duties. The question is whether he will survive, and if so, to what degree he will be impaired.

As doctors began weaning Sharon off the anesthetics that had kept him deeply sedated since Thursday, he began breathing spontaneously, said Dr. Shlomo Mor-Yosef, the hospital director who serves as a spokesman for the medical team.

“This is the first sign of some sort of activity in his brain,” Mor-Yosef told reporters. The prime minister remains connected to a respirator, however.

Several hours later, Sharon moved his right hand and right leg in response to pain stimuli, doctors said.

The stroke affected the right side of his brain, and paralysis is likelier on the left side of his body, which the brain’s right side controls.

It could take days before the effects of the anesthesia wear off enough for doctors to fully assess Sharon’s condition.

At that time, in consultation with the prime minister’s physicians, Israeli Atty. Gen. Menachem Mazuz will decide whether the Israeli leader is permanently incapacitated.

If Mazuz makes that determination, Vice Premier Ehud Olmert, who has been serving in Sharon’s stead, would need a Cabinet vote of approval to formally assume the post of prime minister.

Such support is virtually assured, in part because even in Israel’s take-no-prisoners political culture, few would want to set off an unseemly power struggle at a devastating moment for the national psyche.

If chosen to serve, the 60-year-old Olmert would remain in office for 100 days or until the next election. Voting was already set to take place March 28, and the broad consensus among political leaders is that the balloting should proceed on schedule.

The Kadima party, which Sharon founded less than two months ago and Olmert will probably lead into the election, is favored to win.

In coming hours and days, Sharon’s doctors will continue to test his responses to stimulation such as pain, touch and spoken questions and commands.

The period of emergence from a coma is a dangerous one, doctors say, because increased energy usage and oxygen intake by the brain can lead to more bleeding or a rise in intracranial pressure.

If such events occur, physicians will probably sedate Sharon again and take countermeasures -- developments that would represent a crisis.

Mor-Yosef described the movement of Sharon’s right hand and leg in response to pain stimuli as “slight but significant.”

“In this case, that’s a positive reaction,” he said.

Sharon fell ill Wednesday night at his ranch in the Negev desert on the eve of a heart catheterization procedure meant to reduce his risk of stroke. He had suffered a minor stroke Dec. 18 when a blood clot traveled to his brain.

Sharon’s doctors decided to start bringing him out of his coma Monday after checks showed that his blood pressure, heartbeat and other indicators were within their normal ranges.

“When his reactions to pain become more significant, when his limb movements become more significant, later on we expect his eyes to open,” said Umansky, the surgeon. “But between one stage and another, several days could pass.”

For many in Israel, the ordeal was akin to a sojourn in a hospital waiting room, wondering whether someone dear would survive. Israelis are accustomed to coping with immediate crises such as suicide attacks or bus bombings, but the drawn-out nature of Sharon’s medical drama left many feeling frayed.

Israelis also were mindful of their leader’s lifelong capacity to surprise.

“With him, you really just can’t tell,” said Moshe Avraham, a young Tel Aviv resident sitting with his girlfriend on a park bench. “It’s not logical, but I can’t help thinking he might confound everyone and overcome everything -- just like he always did.”

Times special correspondent Tami Zer in Tel Aviv contributed to this report.