BLOCK MAY LOSE SOME FUNCTIONS, NEUROLOGISTS SAY; LOCATION OF BLOOD CLOT CRITICAL.

Byline: Lee Condon Daily News Staff Writer

Neurology experts said Wednesday that the type of brain surgery performed on Sheriff Sherman Block could lead to paralysis or loss of the ability to speak, walk and see, depending on the location of the blood clot that was removed.

``It's a wide range of outcomes. It's contingent on where the clot was,'' said Dr. Gary Heit, an assistant professor of neurosurgery at Stanford University Medical Center who has performed the surgery many times.

Block, who is running for re-election against Lee Baca, remained in serious condition Wednesday at USC University Hospital with no significant change, the hospital said in a statement. The sheriff ended up in the hospital Saturday after a blood clot caused him to fall and cut his head, requiring 10 stitches.

The surgical procedure performed Monday on Block, Heit said, is used to treat an otherwise fatal condition caused when blood leaks into the center portion of the brain.

``It probably means it's not in a favorable area,'' he said. ``It suggests it's close to the brain stem or deep in cerebral matter. Patients with deep clots generally don't do well.''

Little information about Block's condition has been forthcoming from his physician, Dr. Srinath Samudrala; officials at USC University Hospital; the Sheriff's Department; or his campaign.

Samudrala has said only that Block had a blood clot deep inside his brain and that his level of alertness has continued to improve. He and others declined to say whether the sheriff is conscious or can speak.

USC University Hospital spokeswoman Brenda Maceo said Block underwent a right front craniotomy, interhemispheric approach evacuation of hematoma. Neurological experts said that means surgeons entered Block's brain on the right side to remove a blood clot inside the brain near where its left and right sides meet.

The doctors agreed the side effects could be loss of the ability to speak, walk and see.

Dr. Paul Vespa, an assistant professor of neurology at UCLA Medical School, said the biggest danger with this type of hematoma is paralysis and that less than half of those who have had the surgery can go back to work.

``It typically causes enough disability (that) they can't perform their job,'' Vespa said.

All patients with such blood clots suffer some damage, he added, noting: ``The hemorrhage itself causes some degree of brain damage. Depending on the brain damage, he may or may not have certain neurological problems. Most people have some degree of neurological deficit afterward.''

Vespa said it would take about three months for anyone to return to work after such surgery, saying it is likely that Block will have to go to a rehabilitation hospital.

Heit said the fact that Block is under treatment for kidney failure could complicate his recovery.

``People with renal failure have trouble recovering from these incidents,'' he said. ``They tend to bleed easier.''

Joe Scott, Block's campaign consultant, said the sheriff's family is coordinating the release of information about his condition.

While the neurologists speaking about Block all may be highly regarded professionals, Scott said only Samudrala is an expert on this particular case because Block is his patient.

Block had insisted throughout the campaign that despite two bouts with cancer and his thrice-weekly dialysis treatments for kidney failure, he was healthy enough to lead the department for four more years. But Baca, a former regional chief for the department, said he decided to challenge Block because he feared that if re-elected, Block might quit midterm because of health problems, and the Board of Supervisors, rather than the electorate, would choose the next sheriff.