Head Injuries

On a recent hockey junket to southern Alberta, I found myself (appropriately for a hockey tournament) in the community of Head Smashed In Buffalo Jump. That night, I slept fitfully at the Head Smashed In Inn, no doubt apprehensive about having to play a team called Head Smashed In. This is one team that does not need a nickname (though “Senators” comes to mind). In fact, I had nothing to fear as I was more at risk of head injury driving to the rink, than I was actually playing the game. Of all head injuries only 10% are a result of recreational activity (playing for the Avalanche excluded). Falls account for 21%, violence for 12% (attending NY Ranger home games excluded) and a whopping 50% from motor vehicle accidents.

The brain sloshes happily about inside the human skull, bathed in a fluid called CSF.

It spends most of its day snapping off synaptic signals, controlling bodily functions and playing condescending mind games with the kidneys. “Hey kiddies, hurry up and piddle so we can go to the Stones concert tonight and… oh wait …ha… kidney Stones!”

When the head receives a sudden jolt, the skull comes to an abrupt stop. The brain, which should have been watching the road rather than analyzing its emotional response to the blonde hitchhiker, actually smacks into the inside wall of the skull. This causes a stunning (concussion), bruising (contusion), bleeding (bleeding), or a sudden decrease of intellect (urge to play hockey). “Hey brainiac,” tease the kidneys “keep your eye on the road or urine trouble.”

1. Concussion

Having your brain smacked and swollen may lead to confusion, loss of consciousness and memory loss, rendering you prime Prime Minister material. The duration of unconsciousness or of the memory bank being closed for service is an indication of how bad the concussion is. A subsequent concussion (even minor), if incurred before the first one heals properly, can lead to dire consequences. After “having your bell rung” , do not risk any reinjury to the head unless cleared by a doctor. Unless raised downwind of Three Mile Island, you have only one head, and damage caused by concussion can be permanent. Athletes will retire after 4-5 concussions, politicians after 8-9 and WWF wrestlers when they start actually getting hit.

2. Bleeding

A leaking blood vessel inside the skull is an emergency. When the brain sloshes about the skull after a collision it may shear a vein allowing a slow leak, or it may shear an artery leading to a more drastic bleed. The skull is rigid but the brain is soft. As pressure increases inside the skull, the brain gets compressed even to the point of being forced down your neck!

A visit to the doctor will prompt ol’ sawbones to grab an instrument called an eye looker-inner. He will place this to his eye and then thrust his face so close to yours, you’ll be able to trade eyelash lice. This prompts an intense giggle reflex in the patient who will snort and struggle not to breathe. Besides checking to make sure the pupils are equal, the doctor is actually shining the light into the back of the eye. He is not examining the eye itself but rather this is the only place in the entire human body where he can directly visualize blood vessels, nerves and the oompa loompas running around inside your skull. What he sees will tell him if any significant pressure is being built up inside the cranium.

Assuming all appears OK for now, he will then send you home with a list of symptoms to watch for including:

1. Protracted vomiting.
2. Unremitting headache that doesn’t clear with Tylenol.
3. Vision blurring as one pupil becomes larger than the other.
4. Acting bizarrely. This is the most important symptom and includes such irrational behavior as having
your words all slurtogethersonobodyotherthanDeanMartincanunderstandathingyousay.
5.Planning your next hockey trip to Wounded Knee Buffalo Jump.

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