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Sarah Burke's Death: A Reminder To Take All Head and Neck Injuries Seriously

Headache, dizziness, confusion, weakness may be signs of potentially fatal brain bleed

 

The action sports world was stunned this week by the death of one of its stars. Canadian freestyle skier Sarah Burke died Thursday at the University of Utah after an injury while training in the Eagle Superpipe at Park City.Sarah Burke holding up X Games gold medal

Burke, a six-time Winter X Games medalist and winner of the Women's Ski Superpipe in 2011, was preparing to defend her title at the Winter X Games Aspen later this month. Toward the end of a training run where she landed on what would later be described as a normal trick, she fell and hit her head. Despite a fall that snowboarding star Gretchen Bleiler later remarked seemed like it "shouldn't even have caused a concussion," Burke was quickly airlifted to Salt Lake City after going into cardiac arrest.

Tests showed a tear in one of her vertebral arteries. Dr. William T. Couldwell, the chairman of neurosurgery at the University of Utah, repaired the tear, and the neurointensive care unit monitored her progress. After nine days in critical condition, Burke died Thursday. According to a statement released by her publicist, "Sarah sustained severe irreversible damage to her brain due to lack of oxygen and blood after cardiac arrest, resulting in hypoxic ischemic encephalopathy. Sarah passed away peacefully surrounded by those she loved."

While sports fans everywhere are shocked at the loss, the frightening reality is that these injuries can actually occur to all athletes and non-athletes as well. I interviewed Raymond Turner, MD, Co-Director of the MUSC Stroke and Cerebrovascular Center at The Medical University of South Carolina, and was surprised that these aren't just freak injuries.

He explained that the vertebral arteries are at risk for injury from whiplash-type injuries because they run inside the bones of the cervical spine and are therefore tethered in relation to the head. "Ms. Burke has been reported to have a tear in the vertebral artery, also called a dissection. The symptoms of a bleeding vessel in the head can cause severe headaches, confusion, weakness, and, if severe enough, coma and death. Repair of this tear should be done urgently to prevent further bleeding."

The reality that we must remember, though, is that these whiplash injuries can result from much less dramatic events. Dr. Turner points out that contact sports, such as football and hockey, and sports where falling is common, such as skateboarding and skiing, are not immune from these injuries. He said that he has even seen several vertebral artery injuries from chiropractic neck manipulations.

Since he adds that no specific group of people seemed to be predisposed to these injuries, preventing vertebral artery dissections is likely impossible. What might be more important for athletes of all sports, and their parents and coaches, to remember is that it is critical to take all head and neck injuries, even the seemingly mild ones, seriously. Symptoms such as confusion, headaches, and dizziness might seem insignificant but can be life-threatening.

"Interruptions in the blood flow in these vessels can result in brain injury that may be minimal, such as short term coordination problems or dizziness, or something that is life threatening. This type of injury can be fatal in some cases, although, fortunately, that is not always the case, and many patients can recover in weeks to months," Dr. Turner stressed.

Sarah Burke leaves behind a tremendous legacy. In addition to being a champion of her sport on the slopes and in the halfpipes, she brought it into the mainstream sports world. In part due to her lobbying efforts, halfpipe skiing will make its debut at the 2014 Winter Olympics in Sochi, Russia. And in her dying moments, her organs were donated to help save the lives of others. Her memory will live on in the hearts and minds of skiers and athletes everywhere. Let's hope that part of that memory serves to remind us of these dangerous injuries as well.


Dr. Geier is an orthopaedic surgeon and sports medicine specialist and the Director of MUSC Sports Medicine in Charleston, South Carolina. He also serves as the Public Relations Chairman of the American Orthopaedic Society for Sports Medicine, a member of the national steering committee for the STOP Sports Injuries campaign, and a columnist for The Post and Courier. For more information on sports injuries, go to his blog at www.drdavidgeier.com.

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