Mercker’s Condition Stabilizes

Until neurologists discover why blood spilled onto the surface of the brain of Angel pitcher Kent Mercker, they cannot narrow a list of treatment options that range from pain relievers to brain surgery.

Mercker remains in stable condition in the intensive care unit of UCI Medical Center today, two days after dizziness and severe headaches forced him to leave the mound during a game at Edison Field. An initial round of tests discovered the bleeding but failed to reveal its cause, according to UCI neurologist John Kusske.

“That’s the mystery they’re working on,” said Steve Giannotta, professor of neurological surgery at USC.

“Is this something scary but benign, something that is unlikely to recur and threaten the patient? Or is there something underlying that could cause great damage that they have to fix right away?”

The most common causes of this bleeding, according to Giannotta, include trauma, an aneurysm and malformed blood vessels. Mercker showed no indication of trauma, a sudden and obvious external cause such as a car accident or getting hit in the head by a baseball.

Dr. Lewis Yocum, the Angels’ medical director, said initial tests did not show an aneurysm or tangled blood vessels and said no surgery is currently planned.

Neurologists tend to repeat those tests to be safe because of the potential severity of those conditions and, if found, the likelihood of surgery, Giannotta said.

Neurologists are particularly wary of an aneurysm, he said, because a second rupture would carry significant risk of death or serious injury.

“It could be a life-threatening situation if there’s an aneurysm hiding in there,” Giannotta said.

Tests have so far ruled out such less common causes as a brain tumor, hypertension and dehydration, Yocum said. Some causes can be treated with medication.

Yocum said Mercker was taking medication “primarily for comfort” Friday. Angel General Manager Bill Stoneman, who visited Mercker Friday, said the pitcher appeared tired but calm and relaxed.

Mercker and the neurologists treating him may never find out what caused the bleeding. In that case, so long as the headaches subside, the mystery may resolve itself without medical treatment and without additional risk to Mercker. Doctors fail to discover a cause in about one of 10 cases and “those patients have a relatively benign course thereafter,” Giannotta said.