Michael Schumacher draws attention to 'talk and die' brain injuries
Blows to the head can be silent killers for which
swift diagnosis is often the only recourse, doctors say.
Even if there is no damage to the outside of the head, the impact
may inflict catastrophic damage to the brain inside, they say.
Because a shock that smashes the brain, a 1.3-kilo organ with the
consistency of soft jelly, against the hard protective shell of the
skull, can damage nerves, brain cells and blood vessels.
Blood clots and bruising then result, which in turn causes
pressure to build up and squeeze the brain, worsening the damage
and amplifying the risk of permanent handicap or death.
Doctors looking at suspected brain trauma can call on X-rays or
hi-tech 3D scanners as diagnostic tools, but treatment options are
relatively few. Drugs may ease rising pressure in the brain but
sometimes surgery is required.
In the case of Formula 1 star Michael Schumacher -- diagnosed
immediately after his skiing accident on Sunday -- neurosurgeons
first operated to tackle bleeding and bruising and then placed him
in an artificial coma after a post-operative scan showed
"widespread lesions" on both sides of the brain.
The lesions "are not good news", said French expert Jean-Luc
Truelle, a retired professor of neurology at the Foch Hospital in
the Paris suburbs. "It shows that there is bleeding across the
brain's function centres."
Tried and tested, the coma reduces the patient's temperature to
around 35 degrees Celsius to reduce swelling. By being unconscious,
the brain is also switched off to sounds, light and other triggers
that cause the organ to use up oxygen as it processes the
"Right now, our goal is to reduce all external stimuli and
oxygenate his brain as much as possible," said Jean-Francois Payen,
head of intensive care at Grenoble University Hospital Centre,
where Schumacher is being treated.
It can take up to 48 hours for symptoms of brain injury to emerge,
which is why anyone who suffers even mild concussion should seek
medical attention, said Dr Truelle.
According to a 2007 Australasian study in the Journal of Clinical
Neuroscience, around one in every 40 cases of head injury
documented over a 10-year period at a major trauma centre were of
so-called "talk-and-die" syndrome.
This means the patients initially felt okay after the incident but
subsequently deteriorated and died from intracranial causes.
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