How a tragic accident turned fatal for Phil Hughes

The side of the neck is probably the worst place you can be struck by a cricket ball. When you have one travelling at speeds of close to 90mph it is a hard missile; and although most injuries from the sport we see are minor – broken toes, split lips and suchlike – there are rare cases where cricketers have been struck in the chest over the heart and suffered cardiac arrest. Being hit on the head is dangerous, of course, but the neck is particularly vulnerable because it is so exposed. The skull has evolved to protect your brain, and so even when it fractures it is not necessarily a bad thing because it is absorbing some of the shock. Unless we see a depressed skull fracture we would not be overly concerned: it is more the damage being done to the vital blood vessels, organs and structures that underlie it that worries us. The shocking death of Phil Hughes, just days before the popular Australia cricketer would have turned 26, has left the sports world wondering one thing: How could this happen? Hughes was wearing a helmet, but in a freak combination of circumstances, his head was turned away from the ball as it bounced up to him. The ball came up below his helmet, outside his face guard, hitting him in a sensitive part of the neck. It smashed the critical vertebral artery, which carries blood from the heart up into the head. Is cricket safe? Death of Phil Hughes raises questions about equipment "That caused the artery to split and for bleeding to go up into the brain," Australian team doctor Peter Bruckner said. "And he had a massive bleed into his brain." While it's incredibly rare for such a thing to happen on a sports field, the injury is not that uncommon in some car crashes, medical literature suggests -- perhaps occurring in 1% to 3% of accidents. Other blunt trauma to the neck, or strangulation, can cause the same damage. It's even possible for the artery to split with no obvious immediate injury, in what specialists call "spontaneous vertebral artery dissection." If that happens, it can be less obviously traumatic than what happened to Hughes, leading to a slow leak rather than the massive bleeding that killed the athlete. About one or 1.5 people in 100,000 suffer spontaneous vertebral artery dissection every year, a review of the literature suggests. It's among the leading causes of strokes in people ages 45 and younger, the study finds.