Image courtesy of: ESPNcricinfo
Cricket Australia doctor Peter Brukner has revealed that batsman Phillip Hughes suffered an “incredibly rare”, freak injury.
Hughes, who was playing for South Australia, tragically passed away after he was struck on the side of the neck by a bouncer from New South Wales pace bowler Sean Abbott. As a result, one of the arteries leading to his brain was compressed and ended up splitting.
“Phillip took the blow at the side of the neck and as a result of that blow his vertebral artery, one of the main arteries leading to the brain, was compressed by the ball,” Brukner said. “That caused the artery to split and for bleeding to go up into the brain. He had a massive bleed into his brain. This is frequently fatal at the time.
“However, Phillip was resuscitated and then managed by, in particular, Dr John Orchard, the Cricket NSW doctor, and paramedical staff, and we were fortunate enough to have Dr Tim Stanley, an intensive care specialist from Newcastle, who was in the crowd and came and helped. They all did an excellent job of keeping Phillip alive and he was able to be transported by ambulance to hospital in reasonable condition.”
After being hit, Hughes was rushed to St Vincent’s Hospital and underwent emergency surgery. Dr Tony Grabs, who is the trauma director at St Vincent’s Hospital, stated that it was crucial to relieve the pressure on Hughes’ brain from the compressed artery right away.
“The head injury that he suffered was catastrophic,” Dr Grabs said. “He arrived well intubated and [had been] resuscitated very well. It was our recognition that the first priority in this situation is to get an urgent CAT scan of the head to determine what we can do. This CAT scan occurred very early and it was recognised early that we had to make an intervention into the brain to actually help get the pressure down in the brain.
“What sometimes happens in the brain is, if you put blood around the brain, a small amount, you will start to become a bit drowsy. If you put a lot of blood around the brain, you will become unconscious. Once we had made the diagnosis of blood around the brain, and it’s a subarachnoid blood, which is under pressure from the artery, the immediate transfer to theatre was necessary. He went to theatre and had extensive surgery to remove some of the skull around his brain to help allow the brain to expand so it wasn’t compressed.”
Following the surgical procedure, which lasted 80 minutes, Hughes was transferred to the intensive care unit, where he remained in critical condition for 48 hours before passing away.
When asked if Hughes could have been saved if he arrived at the hospital earlier, Brukner said: “I think ambulance waiting time is really more relevant when the injured or sick person is not being treated. By any standard or observation he was receiving excellent quality treatment from Dr Orchard and Dr Stanley and the paramedics at the ground, and hence arrived at the hospital in excellent condition.”
Brukner reiterated that Hughes’ injury was a freak accident and added that “there’s only about 100 cases ever reported”.
“This was a freakish accident, because it was an injury to the neck that caused haemorrhage in the brain,” he said. “This condition is incredibly rare. It’s called vertebral artery dissection, leading to subarachnoid haemorrhage – that’s the medical term for it.
“If you look in the literature there’s only about 100 cases ever reported, so this is incredibly rare. Only one previous case ever reported as the result of a cricket ball. So I think it’s important to realise that yes, we need to review all our procedures and equipment, but this is an incredibly rare type of injury.”