Monday, February 11, 2008

Panthers, Pucks, Skates, Carotid Arteries... Huh?

Florida Panthers forward Richard Zednik survived a potentially deadly gash to the neck that partially severed his right common carotid artery (Associated Press link). During the hockey action his teammate fell directly in front of him and the teammate's skate came up to neck level slicing directly into Zednik's right neck. In video of the incident, blood can be seen spraying the ice below Zednik as he falls grasping his neck. He quickly got up and skated to the bench, holding his neck. He was rapidly helped from the ice and later underwent emergency surgery to repair his right carotid artery which doctors indicated was hanging on by only a small thread of tissue. His right external and internal jugular veins were not damaged. As of writing, he was in stable condition in the hospital. He seems very lucky! Doctors say he lost approximately 5 units of blood... that is a bit more than 2 liters. Imagine a 2-liter bottle's worth of bood spilling out of your body. During the surgical repair, the right carotid was clamped for several minutes which would seemingly reduce blood flow to the brain. His doctors said he did not seem to have any brain injury or brain damage due to the interrupted carotid blood supply. Of course A&P students know the left common carotid and vertebral arteries also carry blood to the brain.

There is video of the incident on YouTube if you want to see it for yourself (YouTube link).

A great video for physiology / anatomy students is the medical press conference with the Buffalo Sabres team physician and the emergency surgeons that helped save Zednik... linked here (Buffalo General Hospital). Watch this as it has a terrific discussion of the anatomy of Zednik's injury. Interestingly, the team physician mentions that this injury was not like a previous NHL injury to the neck of goalie Clint Malarchuk which severed his jugular vein. The jugular is a low pressure vein carrying blood away from the head while the carotid is a high pressure artery carrying blood to the head. Large artery injuries are always very dangerous due to the threat of rapid blood loss which could severely reduce blood pressure, causing loss of consciousness and eventually death. As the angiogram below shows, the carotid arteries are large and are located close to the aortic arch and the heart itself... thus a severed carotid artery is serious business and Zednik is lucky to be alive.



Ralph J. Fuentes said...

This was a crazy incident, im glad we dont have ice hockey around here hahaha. The article mentions that the artery collapsed, but because of the vetebral artery and others the brain will still get blood, but if that the artery never got fixed could it survive with the ohter arteries and if so how long would the body be able to live without one of the arteries?

California State University, Sacramento said...

It seems that complete ligation (tying the vessel off) can be okay in young patients but in older adults it would possibly cause stroke and loss of vision and more. I think they would have tried to stop the blood loss and then reconstruct or bypass the injured vessel. So , I will assume we need both common carotids until I see something that says different. Good questions though.