Schumacher suffers from cerebral hemorrhage, now in critical condition (5th Update)

UPDATE #5

Schumacher skiing in 2007 when he was still a Ferrari driver

Leading neurosurgeon Christopher Chandler said the hematoma and bruising the seven-time Formula One World Champion suffered during a skiing accident could cause "ferocious swelling".

"An intra-cranial hematoma is a blood clot, which causes swelling and pressure on the brain," said Chandler, who is a consultant with the London Neurosurgery Partnership.

"The scenario may be that he had a blood clot in his brain that required immediate removal, which would explain the surgery.

"By bilateral lesions, I suspect they mean contusions or bruising to the brain. That bruising of the brain, which you can see on a scan, causes ferocious swelling and that is really serious.

"(Cerebral) contusions are often the most significant injury. Once you remove the clot, the swelling carries on and bruising precipitates and propagates that swelling.

"If you have a brain injury with sufficient severity to cause a coma, that indicates a very serious situation. The longer a patient is in a coma, the less likely they are to make a full recovery.

"You can't say that they won't recover, and you can't say they won't be brain-damaged, but an injury such as bilateral bruising, which means on both sides of the brain, is very serious, and can be very dangerous."

The consultant continued: "Brain swelling takes a number of days to reach its peak. The brain has a rigid unyielding box around it – the skull – which allows no room for growth, making swelling very, very dangerous.

"And once that injury occurs it's a vicious circle where a little bit of swelling causes more pressure, which causes more swelling, more pressure, and it starts to accelerate and affect vital parts of the brain.

"When that happens, you are in really deep trouble, but this man received probably the best possible care that you could imagine in the circumstances.

"He had the brain injury and within minutes a team of medics were there and they airlifted him to hospital. Within half an hour he was assessed and being flown to the neurological unit in Grenoble." Sky Sports

12/29/13 Gary Hartstein, a former Formula One trackside doctor, said: "The brain's plasticity makes prognosis impossible to pronounce definitively for quite some time. Weeks to months."

The nature of Schumacher's treatment "suggests that something very serious has happened", said Chris Chandler, consultant neurosurgeon at King's College hospital in London.

"Certainly after blunt trauma, which is what you would term his injury, the brain does swell and that swelling contained within the rigid box of the skull can cause dangerous pressure on the vital structure to the brain," he told Sky News. "That brain swelling needs to be controlled. The fact that he was wearing a helmet simply means that it has minimized the severity of the injury but still it is possible to sustain a serious injury even with the helmet."

Chandler said the fact that Schumacher, 44, was in a coma meant he could have suffered a number of different injuries. "He could have suffered a diffuse injury to his brain, which can then result in brain swelling. He could have sustained some sort of brain hemorrhage and if there was a blood clot within his brain or on the surface of his brain underneath his skull, that might need to be removed."

"Sometimes there is nothing actually to remove but you put in an intracranial pressure monitor, which basically is an operation that requires drilling a hole in the skull and putting a fine probe inside. Or if there is diffuse swelling of the brain, sometimes surgeons remove a large piece of the skull … so there is space for the brain to swell to minimize the pressure on vital structure.

"It's not clear from the reports that I've heard exactly what the nature of this emergency operation was. But the fact that they undertook something almost immediately, that he was admitted to the surgical unit, suggests that something very serious has happened."

Hartstein said the fact that Schumacher was conscious and speaking immediately after the accident was common. "It's quite well known that extradural hematomas, a kind of cerebral hemorrhage, can leave a lucid interval after injury.

"Then as the hematoma forms, the increase in pressure causes sudden and dramatic symptoms. Pressure must be relieved rapidly," he said. He said the coma could be induced.

"Let's demystify it just a bit. Any severe head injury leads to a loss of co-ordination of tongue and throat muscles. This happens to some when they sleep – called snoring. But this is respiratory obstruction and causes carbon dioxide to rise and oxygen to fall," he explained.

"But the brain wants oxygen and hates CO2. So we put tubes in these patient's tracheas and use respirators. This protects the airway and gives excellent control of ventilation and oxygenation.

"But to intubate someone, he or she needs to be pretty deeply anaesthetized. So this is the usual 'artificial coma'. It is an induced coma, but in fact it's like a prolonged, protective, anesthetic."

Gary Hartstein tweets as @former_f1doc. His responses were edited from his tweets.

12/29/13
Apparently it's (far) more serious then we all think (or hoped it to be). Michael Schumacher is suffering from a brain hemorrhage. The former German driver, currently hospitalized at the University Hospital of Grenoble, has been downgraded to critical condition. His prognosis is engaged. He fell Sunday morning ski in Meribel and struck a rock with his head. Hospitalized initially in Moutiers, the seven time world champion was transferred in mid-day in Grenoble.

Schumacher was in a coma when he arrived at the University Hospital Center of Grenoble and required immediate brain surgery, hospital officials said in a written statement.

Christophe Gernignon-Lecomte initially told CNN affiliate BFM TV that the injury "is not very serious" but the station later reported it to be "severe head trauma," citing police.

12/29/13 (GMM) Michael Schumacher has been injured while skiing in France, media reports said on Sunday.

The incident occurred off-piste at the Meribel ski resort, where the seven time world champion has a chalet.

Former Ferrari and Mercedes driver Schumacher, 44, was wearing a helmet while skiing with his 14-year-old son when he fell and struck his head on a rock.

The German was airlifted to hospital, according to resort director Christophe Gernignon-Lecomte.

"He was in shock, a little agitated, but conscious," he is quoted by RMC Sport.

"It could possibly be a cranial injury but it is not very serious."

Earlier reports suggested Schumacher, who was transported from Moutiers hospital to Grenoble, had suffered a serious head injury.

But after speaking to his manager Sabine Kehm, the major daily Bild reported: "There is no danger to his life!"

Kehm said: "We ask for your understanding that we cannot give continuous information about his health. He was wearing a helmet and was not alone."

12/29/13 French media organization Europe 1 reported that he had been taken to a hospital with a head injury, but we hear it is not serious – he hit his head on a rock while skiing out of bounds. Although he has a concussion, the helmet he was wearing saved him.

The accident reportedly happened while the 44-year-old was skiing in the French resort of Meribel in the popular Three Valleys ski area.

It is understood he has been taken to Grenoble Hospital by helicopter.