Jason Mitchell, Seismic Nationals 2007, Hybrid Slalom.  Photo by Greg Fadell Northern California Downhill Skateboarding Association
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Dr David Hartman on Head Injuries

 
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Q&A: Dr David Hartman on Head Injuries (824 Posts)
Topic Comment
The Cazy Downhill skate
On 5/9/2007 Gabriel wrote in from Brazil  (201.32.nnn.nnn)

loock !!!
http://pe360graus.globo.com/foradoeixo/matLer.asp?newsId=70095

 
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Helmet in Concrete Wave
On 4/30/2007 Dr. Dave wrote in from United States  (68.253.nnn.nnn)

Good for CW! Helmets are as much a part of boarding as goggles and gloves are for skiing. Even the X-Gamers wear protective gear. My take on it is that you don't lose any street cred when you wear a helmet. Plus, you get to keep your head from looking like Frankenstein's kid brother.

Dr. Dave

 
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Helmet symposium
On 4/30/2007 yoyo schulz wrote in from Germany  (62.225.nnn.nnn)

Just for info: The latest issue of Concrete Wave Mag has a few pages of helmet infos and a rundown of statements from the various helmet manufacturers.
Have you ever seen something like this in a mainstream mag? I seriously doubt it.

 
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More Pictures Please
On 4/28/2007 Kate wrote in from United Kingdom  (81.151.nnn.nnn)

Hi

I need more photos please, I am working at the local skate park and trying to get everyone to wear helmets is difficult at times. I am hoping dislaying some pictures will help!!

Thanks

 
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Under the Flip Top
On 3/26/2007 Dr. Dave wrote in from United States  (68.251.nnn.nnn)

Thanks Haggy for the new 'my head now has a pop top' poster. What's interesting about the pic is what you don't see. Underneath the stitches, with bleeding in the brain, there is likely to be brain damage that won't easily go away.


Even if you don't use your brain for rocket science, you need it to skateboard. If your brain isn't working right, there's no way you can do the balancing and quick decision-making you need to board. So if you really care about boarding and want to keep doing it for a while, you've got to have the helmet.

Thanks again,

DrD

 
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head injury
On 3/25/2007 haggy wrote in from Australia  (124.189.nnn.nnn)

a fellow downhiller/slalomer in queensland came off last month and cracked his head hard.

The result:
- Fractured skull in two places
- Bleeding on the brain
- Emergency surgery
- 12 days in hospital
- 40 staples in the skull

 
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aussie kid gets hurt
On 3/15/2007 haggy wrote in from Australia  (124.189.nnn.nnn)

news from sydney, oz

hope the kid pulls through ok. wear your lids folks, concrete is tougher than your skull...
------------------------------------- -----------

Skateboarder, 12, airlifted to hospital
Email Print Normal font Large font David Braithwaite
March 16, 2007 - 12:27PM

A 12-year-old skateboarder has been airlifted to hospital with serious injuries after slamming head-first into a concrete skateramp on Sydney's northern beaches.

Ambulance crews were called to Avalon Skate Park about 11am and called for a rescue helicopter upon realising the extent of the boy's injuries, a spokesman said.

The boy had serious head injuries after falling head-first on to concrete at the skate park, he said.

He was taken to Royal North Shore Hospital by helicopter shortly afterwards.

Police are at the skate park and making enquiries into the accident, a spokesman said.

 
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Jason don't suck
On 3/5/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Jason,

Sorry for the bad hit, but you are now the local movie star poster boy for wearing helmets. Good job. In fact, if you save even one life or prevent even one disabling injury - that's more than most people in the world can claim and is major good karma.

As for the lump, it's normal for that indentation to be there. The skin probably stretched over the lump and now that it's gone, it will take a while to tighten up. If it doesn't go away to your satisfaction, you could always see a plastics doc who could do a little bit of a tuck up by removing some of the stretched skin and sewing the rest up. That's what super-fat people do when they lose a lot of weight.. . . :)

SkateSafe DrD.

 
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head lump
On 2/23/2007 jason wrote in from United Kingdom  (84.71.nnn.nnn)

hi i have had a lump on the back of my head for about 3 years. today i had it drained at my doctors and what came out was just gooey blood but now there is an indentation in my head feels like part of the muscle missing is this normal.

 
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sucks but i might have saved my friends too
On 2/17/2007 jason wrote in from United States  (72.189.nnn.nnn)

I busted at the bottom of a hill doin 45, and i fractured my skull in two places, broke my clavical, and had a brain contusion. I wasnt wearing a helmet. My mother was jogging right behind me and saw me laying down and slapped my face to get me up and when she pulled her hand away from my ear it was covered with my blood. After being taken to the hospital I had brain surgery after a week and a half of almost dying every day, putting my family and friends through the worst hell they could ever have imagined. Thank god I came to a few days after surgery and after weeks in rehab which began to feel like jail (s#@!ty food, and bein strapped down in bed every night) they finally pulled the 38 staples out of my skull, took out the stitches and let me go home. I didnt go too much into the details because I know other people have posted similar stories on here, and mine is a lot alike. The point I want to make is this: When i was in rehab my best friend came and took a picture of my head staples, crusty blood, stitches, swelling and all, and printed it off for me on a huge sticker, and put it on the side of my helmet (which i had just got 2 days before the spill, but had left at home) and wrote "zipperhead i dont wanna die" across it. THen all my fiends went out and bought helmets too (we had never worn them, parks, pools, hills whatever). I guess my point is that if somethin like this has happened to you then use it as an awesome oppurtunity to save some lives. We gotta look out for each other, you know, we're like family. It makes me so happy when i go to parks now and people come up and ask me about it and people without helmets actually leave, buy one, and come back to skate. NEver be discouraged, by puttin yourself out there you may be savin lives without knowin it.

 
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Yasmin's Question
On 2/10/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Yasmin,

First, I hope that we all will put our hearts together to wish your son a full recovery. You don't say when your son's most recent surgery was, and individuals who have had brain surgery within a month or two should always get their doctor's clearance before flying.

Your son's medical condition is another factor. There is somewhat less oxygen in commercial plane air, and flying, especially, on long flights, increases blood carbon dioxide and can cause edema (swelling). If there is air inside his brain, that may be another risk factor. Air travel does not seem to causes seizures per se, but if you son has a high frequency of seizures or if he has had seizures on a plane before, he is at higher risk for seizures while flying. People who are prone to develop deep vein thrombosis (DVT's, basically blood clots) while flying also should take special precautions that a doctor will explain to you.

I would ask these questions of your son's neurologist or neurosurgeon before he flies. There's no single answer and whether your son can fly depends upon a lot of factors. Only the doctor who knows his case details and medical records can give you a 'yes' or 'no' on this one. Best of luck to you and your son.

DrD

 
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head injury
On 2/10/2007 yasmin neil wrote in from United Kingdom  (62.254.nnn.nnn)

MY SON WAS ATTACKED IN FEB 2006. HES NOW HAD 4 OPERATIONS THE LATEST ONE WAS HAVING HIS BONE FLAP REMOVED.HE NOW HAS TO WAIT 7 MONTH FOR A TITINIUM PLATE.COULD YOU PLEASE ADVISE ME IF IT IS SAFE TO FLY, IN THE MEANTIME THANK YOU.

 
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Dents 'r Us 2
On 2/7/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Cash'ae:

Head dents can be in the muscle, or the bone. Some bone "dents" like a heavy eyebrow ridge, can be caused by vitamin deficiency. Unless you have no bone under a skull "dent" which could be a problem, dents are mainly cosmetic issues. Plastic surgeons and dermatologists have "filler" substances that mimic natural tissue and which can fill out the dents. Again, if the appearance bothers you, a doc might be able to spackle it from the inside.

DrD.

 
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A dent in my Head
On 2/6/2007 Cash'ae wrote in from United States  (12.7.nnn.nnn)

Hey DOc How r U , I have a head full of dent and I can't explain how or why, they dont hurt and their only in the back of my head, but i would like to know If it could cause brain damage or some kind of illness. Please help . I need answers

 
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Dent's 'R Us
On 1/31/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Linda,

You didn't say how deep the dent is, but unless you can store loose change in it, it is unlikely to be more than a cosmetic issue. If the look of it bothers you, I'd suggest contacting a local plastic surgeon to see if it can be "filled in."
Let us know.

Dr.D.

 
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Dent along the edge of the fontanelle
On 1/30/2007 Linda wrote in from United Kingdom  (82.41.nnn.nnn)

I have a dent about an inch and a bit long at the front of my head which I have just started to notice over the last few months. I have a feeling it is getting deeper but it may just be my imagination. I haven't bumped my head recently, but now and again in the past i have caught that particular spot on the edge of a kitchen cupboard door - I have a slight dent on my forehead that I think was caused by the same thing. Neither are painful and I don't think I have any other symptoms - should I get this checked out?

 
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Scalped
On 1/29/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Ciji:

A scalp hematoma is a bruise or "goose egg" underneath the skin and is typically caused by an accidental, (typically minor if that's the only symptom), impact injury. But if that lump is an infection, that's something different. You need to ask you daughter's doctor which diagnosis for the "goose-egg" was correct, a bruise (hematoma) or an infection (pus) under the skin. Also please make sure your daughter is followed up by her pediatrician. Any infection around or under the skin on the head could spread to the the eyes or even the brain. It's not something you want to treat on your own. Let us know what happens and hope your daughter recovers soon.

 
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my daughter
On 1/29/2007 Ciji wrote in from United States  (205.204.nnn.nnn)

my daughter got a chemical burn from palmolive dishwasher detergeant her head started to get infected and smelled like it was rotning i shaved her hair off the whole back of her head was a soft spot that went around to the right side of her head one morning we woke up and her head and face had swollen making her eye swell togather i called the burn hospital they said put peroxide on her infected area i did that she went to sleep woke up the next morning the swelling was gone the 2nd time was 4 days later the front of her face had swollen i took her to the burn hospital they thought it was infection when they cut her head open to drain they said it was a hematoma on her scalp i know she fell on her bed while having the soft spot at the hospital they took cat scans xrays etc. and there was no fractures so my question is can the swelling from the chemical burn cause this or the fall on the bed with the soft spot or can either one of these cause this? i really need some help figuring this out thank you so much! i dont have a computer i'm using 1 but i'lll come check in a couple days for your response

 
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Sana's Head Trauma - No whine this time.
On 1/23/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Sana,

You don't say if you were knocked out by the accident, but you took a pretty bad hit, even without unconsciousness. I'm concerned as well about the slow blood loss from the nose and where it came from.


If you are being followed medically and nobody is finding anything, and you weren't knocked out, you are probably dealing with the slow recovery of bone, muscle and nerve after being damaged in the accident. If you were unconscious at the scene for more than 20-30 minutes and/or are not being followed medically, and/or if you are having cognitive difficulties that prevent you from doing things you used to do, then it's worth it to see a neurologist and ask if you should have an MRI or other tests. CT's without infusion are not very sensitive to milder brain injuries.


Pain meds like Percoset add their own side effects which dull you out and could contribute to the way you are feeling.


Bottom line: After almost 5 months, it's reasonable to have a neurologist take another look, and possibly a neuropsychologist if you are having significant cognitive difficulty. A pain specialist who can review your pain meds is also a good option. Check this stuff out and let us know. If you have any other questions write again.

Good luck,

DrD.

 
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head trauma
On 1/23/2007 sana wrote in from United States  (71.142.nnn.nnn)

Bad car crash Sept.1st, 2006 from a lady on her cell phone ignoring the stop sign- broken ribs, pneumothorax, punctured lung, ecchymoses on hipbone; and one of the injuries was front right top of head laceration, severed artery; stitches, right nostril leaking blood for weeks, fuzzy memories. Now, I have bad headaches and it feels like there's a hatchet buried in my head with numbness all around it. I have a long dent where I "feel" the hatchet, and several bony bumps, like pearls. It all hurts constantly, yet is numb. X-rays are normal. Initial CTs were ok. Does this go away? Should I see some kind of specialist or just shut up and quit whining? I have to cancel work a lot because of the nausea and pain. My doc has me taking, nightly, Lyrica; daily, 1 every 4 hours, if needed, Percoset; and Imitrix, as needed.

 
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Osgood-Schlatter
On 1/14/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

Osgood Schatter, also known as "growing pains" involve knee pain and swelling. You have to at least go to your doctor to make sure that's what you have. If you are playing school-based soccer, they should be able to point you to a school sponsored or approved sports medicine clinic, or someone who will look at your knee for not much fee.

I can't officially recommend a treatment, but here's what you can find on www.emedicine.com about Osgood-Schlatter. They basically recommend conservative treatments (ice, analgesics, activity restriction, stretching, strengthening, or anti-inflammatory medications), are available. Once the diagnosis is made and other pathologies are ruled out, the patient may be discharged with primary care or orthopedic referral. Therapy is conservative.
Initial treatment includes the application of ice for 20 minutes every 2-4 hours. Analgesics and nonsteroidal anti-inflammatory medications (NSAIDs) may be given for pain relief and reduction of local inflammation.
Inform the patient to avoid pain-producing activities (eg, sports that involve excess amounts of jumping). Use of a knee immobilizer for a few days may improve compliance, especially in more severe cases. Pads or braces also can be used for support. Once the acute symptoms have abated, quadriceps-stretching exercises, including hip extension for a complete stretch of the extensor mechanism, may be performed to reduce tension on the tibial tubercle. Stretching exercises for the hamstrings, which are commonly tight, may also be performed. Consultations: Refractory cases unresponsive to conservative treatment should be referred to an orthopedist for possible surgical intervention. However, surgery is rarely needed.


Good luck

Dr. Dave

 
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Even with a helmet
On 1/14/2007 Dr. Dave wrote in from United States  (24.13.nnn.nnn)

That's a fantastic picture, because without the helmet, you'd probably be able to see pieces of brain and the picture would be taken from a slab. Yeah, injuries can be gross, but gross is less bad then dead. Think about it and keep the helmet on.

Dr. Dave

 
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osgood schlateral disease
On 1/5/2007 john wrote in from United States  (70.251.nnn.nnn)

i have osd and i play soccer but sometimes i can't play because of pain, i can't afford doctor visits, any reccomendations to stop pain when im playing

 
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Even with a helmet
On 12/28/2006 patrick wrote in from United States  (69.242.nnn.nnn)

Photobucket - Video and Image Hosting

And he was wearing a helmet.

 
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oh those attractive scars and slurred speech
On 12/21/2006 snoball wrote in from United States  (72.185.nnn.nnn)

That's right Doc. Dain Bramage not good is.

And btw, that myth about 'chicks digging scars' was, of course, started by guys with scars told to nieve guys without them. Guys, the truth is, it's generally a myth if they're all over your face LOL

Happy Holidays Dr.Hartman and since skaters are not known for always playing by the rules of common sense, including me, it's nice to know that you have made yourself available to the posters here.

And the skate gods shone their face upon him and said unto him: "Dr.Hartman, you rocketh greatly" ;)

 
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