29 Aralık 2013 Pazar

Michael Schumacher"s injuries – the doctors" view

Staff outside French hospital emergency department

The emergency division at the CHU hospital in Grenoble, where Michael Schumacher is becoming taken care of. Photograph: Robert Pratta/Reuters




The complete impact of brain injuries such as people suffered by Michael Schumacher on Sunday can take months to diagnose.


Gary Hartstein, a former Formula One particular trackside doctor, explained: “The brain’s plasticity tends to make prognosis extremely hard to pronounce definitively for very some time. Weeks to months.”


The nature of Schumacher’s therapy “suggests that some thing really serious has took place”, said Chris Chandler, advisor neurosurgeon at King’s University hospital in London.


“Surely soon after blunt trauma, which is what you would term his damage, the brain does swell and that swelling contained inside of the rigid box of the skull can trigger hazardous strain on the crucial framework to the brain,” he told Sky News. “That brain swelling needs to be controlled. The fact that he was wearing a helmet basically signifies that it has minimised the severity of the injury but still it is achievable to sustain a critical damage even with the helmet.”


Chandler mentioned the truth that Schumacher, 44, was in a coma meant he could have suffered a quantity of various injuries. “He could have suffered a diffuse injury to his brain, which can then end result in brain swelling. He could have sustained some kind of brain haemorrhage and if there was a blood clot inside of his brain or on the surface of his brain underneath his skull, that may well need to be removed.”


“Occasionally there is absolutely nothing in fact to remove but you put in an intracranial stress keep track of, which generally is an operation that demands drilling a hole in the skull and placing a fine probe inside. Or if there is diffuse swelling of the brain, occasionally surgeons get rid of a massive piece of the skull … so there is space for the brain to swell to minimise the stress on essential framework.


“It truly is not clear from the reports that I’ve heard exactly what the nature of this emergency operation was. But the fact that they undertook something practically quickly, that he was admitted to the surgical unit, suggests that anything quite significant has occurred.”


Hartstein said the truth that Schumacher was conscious and speaking instantly soon after the accident was frequent. “It is quite properly recognized that extradural haematomas, a type of cerebral haemorrhage, can depart a lucid interval after damage.


“Then as the haematoma kinds, the enhance in stress brings about sudden and dramatic signs. Stress have to be relieved swiftly,” he mentioned.He stated the coma could be induced.


“Lets demystify it just a bit. Any extreme head injury leads to a reduction of co-ordination of tongue and throat muscle groups. This happens to some when they rest – called snoring. But this is respiratory obstruction and brings about carbon dioxide to rise and oxygen to fall,” he explained.


“But the brain desires oxygen and hates CO2. So we place tubes in these patient’s tracheas and use respirators. This protects the airway and gives excellent control of ventilation and oxygenation.


“But to intubate a person, he or she demands to be rather deeply anaesthetised. So this is the normal ‘artificial coma’. It is an induced coma, but in reality it truly is like a prolonged, protective, anaesthetic.”


Gary Hartstein tweets as @former_f1doc. His responses had been edited from his tweets.




Michael Schumacher"s injuries – the doctors" view

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