Caused by Fall Off Horse : Reagan Survives Brain Surgery to Remove Fluid

ROCHESTER, Minn. —  Former President Ronald Reagan underwent successful brain surgery Friday afternoon for removal of fluid that apparently resulted from his horseback-riding accident two months ago, his spokesman said.

“President Reagan is conscious and recovering in his room, where he is comfortable and in good spirits,” said spokesman Mark Weinberg.

Weinberg said the hourlong surgery, performed at St. Mary’s Hospital by a team of Mayo Clinic surgeons, went “without complications.” The 78-year-old former President “will be carefully monitored, although no further treatment is anticipated,” he said.

The fluid on the right side of the brain--blood that accumulated over a period of time--was found during a routine examination at the Mayo Clinic, Weinberg said. Fluid on the brain can cause pressure that can damage or kill brain cells.

Routine Procedure

Although Reagan did not experience any symptoms, physicians advised that the fluid be removed in a routine procedure, Weinberg said.

He said the surgeons made a “small burr hole” in Reagan’s skull and drained a collection of fluid.

“The procedure, which was performed under a general anesthesia, lasted slightly over one hour and was without complications.”

Weinberg said he did not know how long Reagan will be hospitalized.

Mayo Clinic physicians said the former President is otherwise in excellent health, Weinberg said earlier. Reagan’s wife, Nancy, who also underwent routine tests, was found to be in excellent health as well, he said.

Bush Tried to Phone

Weinberg’s description of the President’s problem as a “subdural hematoma caused by President Reagan being thrown by a bucking horse in July” indicated that the fluid had collected underneath the dura, a membrane that covers the brain inside the skull. A hematoma is a pool of blood, as in a bruise.

The blood had collected on the top of the right side of the brain, Weinberg said.

President Bush tried to phone his predecessor from Air Force One en route from New Orleans to Washington, but Reagan had already entered surgery.

“I hope it’s all right--pray it’s all right,” Bush told reporters.

The Reagans arrived in Minnesota on Wednesday and checked into the clinic Thursday. They left the clinic Friday morning and he later checked into St. Mary’s, said a hospital spokeswoman who would not be identified.

Reagan, an accomplished rider, was thrown from a bucking horse July 4 while visiting the ranch of William Wilson, a friend, near Cananea, Mexico, about 30 miles south of the Arizona border.

He was flown to an Army hospital in Arizona and kept about four hours, declining a doctor’s suggestion that he remain overnight for observation. He was described as suffering from scrapes and bruises and advised to avoid stressful exercise for a few days.

The Reagans have a long relationship with physicians at the Mayo Clinic, in this city 70 miles southeast of Minneapolis. Mayo doctors took part in Reagan’s care while he was President, and in October, 1987, two Mayo physicians were part of a team that treated Mrs. Reagan’s breast cancer.

Frank Iossi, communications director at the clinic, said he would not comment beyond Weinberg’s statement.

Doctors Not Identified

Mary Ellen Landwehr, a clinic spokeswoman, said that, at the Reagans’ wish, the clinic would not announce the names of doctors who performed the operation.

Based on the Mayo Clinic’s statement, Henry Brem, a neurosurgeon at Johns Hopkins University Hospital in Baltimore, characterized the operation as a fairly minor procedure.

“Patients usually do beautifully in something like this,” said Brem, who was not among doctors performing the surgery on Reagan.

In the case of subdural fluid, surgeons drill a series of holes and then use a saw to remove a piece of the skull, he said. The fluid is then drained, the dura stitched back together and the piece of skull replaced, Brem said.

The procedure normally takes one to four hours, he said, and usually requires a week’s hospital stay.

Problem Not Unusual

Dr. Edward Laws, chairman of neurosurgery at George Washington University Hospital, said it would not be surprising if the jolt from a fall, particularly with an elderly person, would cause a collection of fluid on the brain.

“This is usually because a little blood vessel gets torn and causes some blood to leak into the space over the surface of the brain,” said Laws, who was not involved in the surgery.

He said it is common practice to remove such fluid collections, even if they are causing no problems. “They usually continue to enlarge and could ultimately cause symptoms,” Laws said.

The Reagans have lived in Los Angeles since he left office in January.

During his two terms, Reagan was hospitalized several times, recovering from various ailments at a speed doctors called impressive for a man his age.

Wounded by Assassin

On March 30, 1981, Reagan was wounded in an assassination attempt. A bullet one inch from his heart was removed, but by Oct. 30 he was declared in excellent health.

On July 13, 1985, he underwent successful surgery for cancer of the colon. Later examinations during the balance of his second term showed no recurrence.