Friday 15 December 2017

Early signs are re-assuring - but concern with head injury is always brain rather than skull

Ryan Mason of Hull City lies injured after the collision with Gary Cahill. Photo: Getty
Ryan Mason of Hull City lies injured after the collision with Gary Cahill. Photo: Getty

Peter Hamlyn - Consultant neurosurgeon

The fact that Ryan Mason is already talking so soon after suffering his injury is incredibly reassuring for his future both on and off the field.

The type of procedure he underwent on Sunday night is as straightforward as any neurological surgery can be, and Petr Cech stands testimony to the fact that many in professional sport do make a complete recovery.

Details are scarce but that operation may have had several purposes.

The most likely of them is to ease the pressure on the brain. In a clash of heads the skull most commonly fractures if the side of the head, a relatively weak part, is struck by a comparatively strong part of their opponent's - typically the front or top. That was the case in this incident.

If that happens and the bone is pushed in it causes pressure on the brain and when this indentation is too great it has to be lifted and repaired.

The concern in any head injury is always with the brain rather than the skull, but a fracture can cause bleeding and potentially lethal pressure as a result; surgeons look for this and control it.

One thing we can take heart from is the fact that Gary Cahill, with whom he clashed heads, was relatively unharmed. That reduces the probability Mason's brain was damaged, although that clearly did not mean he was not in danger.

Severe brain injury can occur without the skull being fractured - none of the boxers I have operated on for brain bleeding had suffered fractures. In fact skull fractures are, on the whole, rare injuries even in collision sports such as rugby.

Instead they are more likely to be found in equestrian or motor sports - Ayrton Senna suffered skull fractures in the accident that claim his life.

Surprisingly, skull fractures are perhaps most common in golf with the victim often a novice standing too close to a fellow player as they tee off.

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