Speed is vital in treating a violent head injury of the kind suffered by 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, Hughes was given mouth-to-mouth resuscitation and was mechanically ventilated with oxygen in the ambulance on his way to hospital.
There he will 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 surround 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 given drugs to place him in a temporary coma. This can be vital if ruptured blood vessels are unable to deliver the usual amounts of oxygen and nutrients, as 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.
Jeremy Laurance is the former Health Editor of 'The Independent'Reuse content