PHILADELPHIA - (KRT) - What caused Terri Schiavo's brain damage remains a mystery, but Florida medical authorities Wednesday said the injury was "massive" and irreversible, and left her blind.

An autopsy on Schiavo, who became the focus of a nationwide debate about life and death, found that her brain had atrophied to less than half the normal size, medical examiner Jon Thogmartin said during a news conference in Largo, Fla.

"There was massive neuronal loss," said Thogmartin, chief medical examiner for Pasco and Pinellas counties, referring to brain cells. "This damage was irreversible."

He added that "no amount of treatment" could have repaired the damage. He concluded that she was blind, a key finding because some believed she could follow objects with her eyes.

The report also found no evidence of ill treatment, either before or after her brain was damaged.

Schiavo, 41, died March 31, almost two weeks after the feeding tube keeping her alive was removed. She collapsed in 1990 and, for the following 15 years, was in what doctors testified was a "persistent vegetative state."

She was the subject of a very public, seven-year legal fight over her diagnosis and desires that pitted the Schindler family - her parents and siblings - against her husband, Michael Schiavo. He wanted to remove the feeding tube, arguing that she would not want to live after such serious brain damage.

Her family contended that she was responsive and could get better. As a Catholic, they said, she would have chosen to live, no matter what.

Ultimately, their battle drew in about 40 judges in six courts, the president, Congress and many religious groups. President Bush signed a bill, rushed through by Congress in March, in a last-ditch effort to restore her feeding tube. White House spokesman Scott McClellan said Wednesday the autopsy did nothing to change Bush's position that Schiavo's feeding tube should not have been disconnected.

At the Florida news conference, Thogmartin emphasized that persistent vegetative state is a "clinical" diagnosis made only by doctors who examine a living patient.

But Stephen J. Nelson, chief medical examiner for the 10th judicial circuit of Florida, who helped perform the autopsy, said, its findings are "very consistent with persistent vegetative state."

He said Schiavo's brain weighed 615 grams, 220 grams less than that of Karen Ann Quinlan, the subject of another famous right-to-die debate. Quinlan died after 10 years in a persistent vegetative state, his report said.

Michael Schiavo's attorney, George Felos, said Terri's husband was "pleased to hear the hard science and evidence" that corroborated what he has been saying for years - that Terri could not be fed by mouth, that no rehabilitation or therapy could improve her condition and that she had not been abused.

Felos also noted the finding that Terri was blind, considering the "deep impact on the public" of video footage in which Terri appeared to respond to her mother and follow the movement of a balloon with her eyes.

"We have been saying for years and years and years ... that Terri's eye movement and apparent response to visual stimuli was a reflexive action.

"It's a hard fact, a scientific fact, that Terri Schiavo was blind. She couldn't see her mother," Felos said.

He also said that Michael Schiavo had decided to release to the public some of the autopsy photos, although he did not know when. He has not decided yet what to do with his wife's ashes.

Barbara Weller, an attorney who represented the Schindlers, said the family still disputed the diagnosis of a persistent vegetative state. "They know what they experienced when they were with Terri."

The central moral question, she said, remains. "Is it really moral for us to kill people because their quality of life is not what a judge thinks it should be? We still have to ask in America whether we really want people killed in that way."

Terri's family, Weller said, "didn't care what her physical condition was. They would have loved her and cared for her no matter."

The cause of Terri Schiavo's collapse has never been proven, but testimony in a 1992 civil trial indicated she probably was suffering from an eating disorder that led to a chemical imbalance and heart attack.

Thogmartin said he did not find enough evidence to prove she suffered from bulimia, and was unable to establish exactly what had caused her brain to get too little oxygen and blood in 1990.

Terri Schiavo's parents have accused Michael Schiavo of abusing her, a charge he vehemently denies.

Thogmartin said that there was no evidence immediately after Schiavo's collapse, during her care or from the autopsy itself that she had been the victim of abuse or trauma.

Schiavo, who grew up in Huntingdon Valley, Pa., and later moved to Pinellas County, Fla., died in March, he said, from dehydration, not starvation.

Brain experts who read the autopsy praised its thoroughness and agreed that it showed extensive damage from which there was no hope of recovery.

"This is horrendous, horrific and irreversible," said David Brock, a neurologist at Thomas Jefferson University Hospital.

While doctors cannot tell how well a brain is functioning from an autopsy, Ronald Cranford, a University of Minnesota neurologist who examined Schiavo when she was alive, said he believed "any reasonable person would conclude she was in a vegetative state."

In addition to the blindness, the autopsy showed that Schiavo's hippocampus, the seat of memory in the brain, was profoundly damaged, said Lawrence Kenyon, a neuropathologist at Thomas Jefferson University Hospital. "If you have damage to your hippocampus, you cannot remember anything, so there is no way for you to learn or improve at all," he said. The autopsy would not rule out any higher functioning, he said.

There also was damage to her spinal cord, a sign that "any sensations she was getting below the neck would have been tremendously diminished," said Kenyon, who is director of autopsy at Jefferson. "She might not have been able to feel very much, if anything."

Pamela F. Hennessy, spokeswoman for the Terri Schindler-Schiavo Foundation in Clearwater, Fla., an organization that fought the removal of her feeding tube, said that she was "relieved" that Thogmartin and his staff "were very painstaking and thorough."

"His report, however, does leave a lot of unanswered questions," she said. "It doesn't really offer much in the way of closure, as far as what happened to her. ... There is still no explanation why this healthy, sober, energetic 26-year-old woman fell into this respiratory arrest and ensuing heart failure."

She said that Terri's parents, Bob and Mary Schindler, were unavailable for comment because of a prior commitment.

However, "I don't know if the Schindler family will ever have closure on this. At the end of the day, (in effect,) a judge told them to sit down, shut up and let their kid die."

The Rev. Patrick J. Mahoney, who as director of the Christian Defense Coalition organized protests outside the Florida hospice where Terri Schiavo was being cared for, said the autopsy only energized his cause.

"I think it actually brings more passion and energy into those advocates who worked diligently to save Terri's life," he said.

"It affirms the fundamental position of why we got involved in this case to begin with. ... Terri Schiavo was not terminally ill. Terri Schiavo did not have a sickness. Terri Schiavo was simply disabled, and so a disabled person was dehydrated before our very eyes."

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Link to my previous posts on Terri:
http://herbertsobel.blogspot.com/2005_03_01_herbertsobel_archive.html