Re: Karl Wendlinger
- From: "Dave Baker" <Null@xxxxxxxx>
- Date: Mon, 27 Jul 2009 11:53:51 +0100
"Emma" <Emma@xxxxxxxxxxxxxxxxxxxxx> wrote in message
news:1kQHURG53WbKFA+8@xxxxxxxxxxxxxxxxx
As Richard Miller mentioned in his Report Card, having heard the news
yesterday that the medical team were keeping Massa in an induced coma it
reminded me also of Karl Wendlinger's accident at Monaco back in 1994.
Whilst Karl didn't get hit by flying debris his head did suffer the high
speed collision with the barriers which left him with brain injuries. He
was kept in an artificial coma for three weeks.
Karl did recover and came back to racing but it took him a very long time
and his F1 career was effectively over.
Putting someone into a barbiturate induced coma after head trauma is not
necessarily an indication that the trauma is critically serious. It may just
be a sensible precaution to minimise intracranial pressure given that
there's a fracture involved or as a reaction to sensor measurements of the
pressure.
When any tissue is injured it swells as the body sends plasma and leukocytes
into the damaged area and from burst blood vessels. The brain is
particularly susceptible due to the high concentration of blood vessels to
supply the huge oxygen demand it requires. Being constrained within the
skull such swelling can't just create a bump like on an injured arm or leg
so intracranial pressure builds up which can constrict blood flow and damage
the brain.
Control of intracranial pressure after head trauma is critical to survival
and damage limitation. The primary stage is to control dilation of blood
vessels in the brain as they occupy so much of its volume. Blood vessels
expand and contract as the CO2 content of the blood indicates the need for
more or less oxygen supply to the area. By hyperventilating the patient with
oxygen the blood CO2 level is reduced and the vessels contract creating more
space for any swelling to occur without causing damage. If the medics were
on the ball they may even have commenced this trackside and during transport
to the hospital.
Second stage is to mechanically relieve pressure caused by intracranial
blood or plasma loss i.e. drilling a hole and letting it out.
Third stage is to monitor pressure by inserting tiny pressure sensors. If
it's still high then one way of further contracting the blood vessels to
create more space is to reduce the brains oxygen demand by switching as much
of it off as possible and this is done by inducing coma with pentobarbital
or other barbiturates.
An extreme measure would be to remove portions of the skull to allow the
brain to swell unconstrained.
I'm sure he's being treated with as much care as money can buy and I doubt
if the injuries are actually critically serious from the photos I've seen
but they'll always call a brain injury "life threatening" and it wasn't that
long ago that the actress Miranda Richardson died after bumping her head in
a skiing accident which showed no signs of injury for the first hour or so
and then she suddenly lapsed into a coma and died. Quicker preventative
action would probably have saved her and at least Massa had top class medics
on the scene within minutes.
I'm sure his season is over but hopefully he'll make a complete recovery in
time. Fingers crossed anyway.
--
Dave Baker
.
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