Snipped for focus.
First, many thanks to Donjeta for the time and effort writing the excellent response, and well researched answer to why Jahi can't hear or produce voluntary movement. Thank you! Awesome post!
As to the second and third parts of your question, temperature control, and reproductive maturity.
First, I am not a radiologist or a neurologist, but I'm a health professional, and can see gross/ macroscopic structures on a brain MRI image. Jahi's image has such dramatic destruction of midbrain and brain stem structures that pretty much anyone with a little education can see what "isn't" there. This is not subtle damage that could only be read by a highly educated neurologist or radiologist. It's dramatic, obvious, and horrific, if you have any basic understanding of brain function.
Jahi's hypothalamus (along with the thalamus, pons, midbrain, and other central brain structures) appears to be essentially "missing" (necrosed) in the MRI image from the press conference. One of the things the hypothalamus does is regulate temperature. It is well known that brain dead patients (newly brain dead, still in ICU) have difficulty regulating internal temperature. They become "poikilothermic" (take on the ambient temperature).
http://en.wikipedia.org/wiki/Thalamus
http://www.healthline.com/human-body-maps/hypothalamus
http://en.wikipedia.org/wiki/Pons
http://en.wikipedia.org/wiki/Midbrain
Here is a discussion of poikilothermia in patients with high spinal cord injury. As Dr. Shewmon has noted in his writings over the years, the physiological qualities of brain dead individuals very closely mirrors that of individuals with high spinal cord injury. So, a layer of thick blankets helps insulate, and helps with body temperature regulation. Many body functions (both at the organ level, down to the cellular level) are compromised if the core temperature is too cool, and being too cool, and brain dead, leads to clotting in the microvasculature, increased areas of infection, etc.
http://apparelyzed.com/temperature.html
As for Jahi beginning her menstrual periods, I've written upthread about this. I'll copy that part here.
I also wanted to just touch base briefly on Dolan’s team’s comments that Jahi’s hypothalamic- pituitary- ovarian axis must somehow be intact or functional, since Jahi has had menarche (started her first period.) I think this is an absurd statement, as it’s pretty obvious from their own MRI image flashed up that the pituitary and hypothalamus are “gone”. (Not just damaged, but essentially absent, from necrosis.)
We have to remember that Jahi was a relatively normal, but very overweight, 13 year old adolescent when the events of last December happened. She was on the verge of menarche when she became brain dead, and had obvious breast development in pictures-- she was well into puberty. That means that until she was brain dead, her hypothalamic- pituitary- ovarian axis was intact and presumably functioning normally.
Additionally, her excess body fat would have made her reproductive system somewhat more responsive to endogenous estrogen, which is also produced by fat tissue, as well as reproductive organs. There are studies of children who have experienced traumatic brain injury, with damage to the hypothalamus and the hypothalamic- pituitary- gonadal axis, and still experienced precocious puberty.
http://www.jpeds.com/article/S0022-3476(87)80497-3/abstract
I don’t pretend to understand all of the endocrine issues at the level of a specialist physician or scientist, but I know enough to understand that reproductive systems can continue to function in catastrophically brain injured, as well as brain dead individuals, who were previously normal before the traumatic injury. We see brain dead pregnant women being maintained for varying lengths on life support measures to gestate the end of a pregnancy to viability for the fetus. We also saw Marlise Munoz in Texas, at the end of the first trimester, be maintained on life support for weeks to months, after suffering brain death, and the uterus and fetus continued to grow (although profoundly abnormal at the time Marlise was removed from life support, by reports).
Even the young boy, TK, who was brain dead from meningitis at age 4, for 20 years, went on to develop some secondary sex characteristics, such as pubic hair, and descended testicles. His brain was a small lump of calcified tissue at autopsy, with no discernible structures grossly, nor any neurons microscopically. He also experienced symmetric growth over the years (weighed 75 kg/ 150 pounds at autopsy), with the exception of his skull, which remained microcephalic, since there was no brain growing inside. Disturbing to read, but his brain swelling initially was so severe, the closed cranial sutures actually split open from the inside. Interestingly, his skull was 2.5 cm thickness on the edges (that’s one inch!) at autopsy. That suggests that there are some corporal mechanisms in children and adolescents for some parts of reproductive maturity to occur, in the absence of hypothalamic- pituitary- gonadal axis function. The hypothalamus is also part of the growth hormone feedback system, and patient TK continued to grow symmetrically, in the absence of a hypothalamus and pituitary.
So, I don't think it's strange or unusual that Jahi's body may have achieved menarche. She was essentially at the point of menarche when brain death occurred. I don't think it's necessary for the hypothalamic- pituitary- ovarian axis to be intact for the body to begin menstruation, nor is it evidence of brain function. Lots and lots of female patients with severe brain damage and brain dysfunction continue to menstruate.
Oh-- one other little detail about costs and expenses in the care of Jahi. I had thought NW claimed $200/ month in vitamins and fish oil. She actually tweeted it is $240 a WEEK. She may believe that this expense is necessary, and is free to spend her money on that-- or donated money. But $1000/ month on vitamins for a brain dead teen, for months on end, seems kind of excessive to me. There is no scientific evidence that there is any benefit to this regimen. That is one area that could easily be reduced if there aren't funds to cover it. Or maybe the Internatonal Brain Research Institute, Philip Defina, and his colleagues, could provide the funds for this therapy, since it is only their "advanced care protocol" that advocates the regimen.
http://www.ibrfinc.org/media/IBRF_PRESS_RELEASE-Retrospective.pdf
http://ibrfinc.org/current_research.htm
