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Originally Posted by Zico
Does the fact that he was conscious after reaching the hospital after the fall mean we can afford to be a bit more positive about the outcome than if he was already in a coma... or is it more to do with the damage the swelling might have done and the surgery intrusion level?
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So, lemme give you the basics..
He had multiple epidural hematomas. An epidural hematoma is a collection of blood between the dura mater(sometimes called the tough matter)it's the fibrous covering of the brain that carries the arterial blood supply. What happened is that the inside of the skull, which is actually very rough, cut a few of those arteries. What happens then is that the blood collects, sometimes slow, sometimes rapidly. The case here is that he was unconscious, followed by a time frame of being awake, then essentially, decompenstating into a period of unconsciousness.
The part where that all goes bad is if he would have bled enough to push the brain our of the skull through the magnum foramen(herniation), that's where the spinal cord enters the skull. If that occurs it's 100% fatal.
So, what was done here, is that a head CT or MRI showed the bleeds, and he was subsequently sedated, intubated, and placed on the ventilator. He would have then been taken to surgery to remove the trapped blood. That may have been a craniotomy, or a burr-hole. In extreme circumstances, the can remove portions of the skull, and allow the brain to swell through them, then replace those later on.
He will have been on sedation for brain rest and comfort, with a pressure bolt to measure severity of intra-cranial pressures, a constant EEG for brain activity and IV feeds.
Currently he likely has a tracheostomy, and will slowly be weaned from sedation to judge level of function. until he is fully weaned, we won't know level of dysfunction.
It may be serious, it may be something as simple as memory issues. The fact that he is responding is a great sign..but, it needs to be approached with great restraint. This may be the highest level of function he will ever have, then again, he may be back to drifting Ferrari's like the Stig in two years.
Very hard to say. I prefer the latter to the former, but, neuro injuries are damn near impossible to predict.