Speed is crit­i­cal in treat­ing head in­juries

How doc­tors dealt with hurt Aus­tralian bats­man

The Star Early Edition - - NEWS - JEREMY LAU­RANCE

PEED is vi­tal in treat­ing a vi­o­lent head in­jury of the kind suf­fered by Aus­tralian crick­eter Phil Hughes, to min­imise any fur­ther dam­age caused by bleed­ing, in­flam­ma­tion or re­duced oxy­gen sup­ply.

The brain is like a blanc­mange inside a wooden box and it is se­cured in the skull by veins no big­ger than those on the back of your hand.

A blow to the head can sever a blood ves­sel with rel­a­tive ease.

After col­laps­ing on the pitch this week, Hughes was given mouth-to-mouth re­sus­ci­ta­tion and was me­chan­i­cally ven­ti­lated with oxy­gen in the am­bu­lance on his way to hos­pi­tal.

There he would have had a brain scan to iden­tify the site of his in­jury and whether it had caused a bleed. A ma­jor bleed cre­ates a pool of blood be­tween the meninges – the mem­branes that

Ssur­round the brain – which presses on the brain, re­duc­ing the blood sup­ply to the area af­fected.

Un­less this pres­sure is re­lieved it may lead to per­ma­nent brain dam­age, coma and death.

Emer­gency sur­gi­cal treat­ment, which in­volves drilling through the skull to drain the blood and re­lieve the pres­sure, is life-sav­ing and can pre­vent per­ma­nent dam­age. In some cases, a sec­tion of skull is tem­po­rar­ily re­moved to cre­ate a space into which the in­flamed brain can swell with­out rais­ing the in­tracra­nial pres­sure. The sec­tion of skull is later re­placed.

A spokesman for St Vincent’s Hos­pi­tal in Dar­linghurst, where Hughes was treated, said the surgery lasted less than an hour and the crick­eter had been placed in a tem­po­rary coma. This can be vi­tal if rup­tured blood ves­sels are un­able to de­liver the usual amounts of oxy­gen and nu­tri­ents, be­cause a co­matose brain needs less oxy­gen to func­tion.

Hughes is also likely to have been given di­uret­ics to re­duce the fluid in his body and anti-seizure drugs to pre­vent him suf­fer­ing a fit which could cause ad­di­tional dam­age.

The spokesman said it would be 24 to 48 hours be­fore the out­come of surgery was known. – The In­de­pen­dent

CRIT­I­CAL: Aus­tralian crick­eter Phil Hughes was hit by a bouncer.

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