Here's the final story on Franzen.
http://blog.mlive.com/snapshots/2008...plains_it.html
As MLive.com's own
Ansar Khan reports, the Red Wings finally revealed on late Friday/early Saturday that Johan Franzen had suffered a sub-dural hematoma, or, in layman's speak, a bruise on the side of brain.
In technical speak? The brain--whose tissue has a slightly "mushy' consistency--and nerves essentially "float" in something called
cerebrospinal fluid. As the brain floats and sloshes around when you move, there are layers of tissue called
meninges, surrounding those nerves and especially the brain. Meninges are the physical "stuff" that separates your brain and the inside of your skull. The innermost layer of meninges/stuff is called the
pia mater, the middle layer is the
arachnoid mater, and the outermost layer of tissue is called the
dura mater, which is very tough and actually provides the brain's physical attachment to the skull.
When you get a bump on the head, your brain bumps into the meninges, which help prevent your brain from getting damaged by the skull. When you suffer a concussion, it's your brain that ends up getting bruised; when you suffer a subdural hematoma, it's the meninges that gets bruised, and, specifically, it's the area
between the dura and arachnoid mater.
Like any bruise, blood collects and clots, but when you're dealing with a bruise within the cerebrospinal fluid, unless that bruise is allowed to go away naturally, some of that clot can break off and move within the cerebrospinal fluid, and cause a stroke or more internal bleeding. That's why they completely shut Franzen down and gave him multiple MRIs over a short course of time.
That's why both Wings coach Mike Babcock and the team's trainers were deferring to the team's medical staff--Babcock never said Franzen could return when Piet Van Zant cleared him--that's why the Wings were using the term, "concussion-like symptoms," and that's why no one, from Ken Holland to Babcock, Van Zant, or Franzen himself, were talking about baseline neurological tests or concussion specialists.
The
first thing you're checked out for when you're exhibiting any symptoms related to a concussion is bleeding, usually via a CT scan, and once that's ruled out, the neurological protocols for concussion treatment follow. In Franzen's case, the first thing they found was a hematoma, so they were more worried about determining the size and shape of the hematoma and whether it could dissipate without the use of blood-thinning medications first, and while they eventually were able to rule a concussion out, the Wings' doctors could only wait and hope that the "concussion-like symptom" would heal on its own.
This also explains why Franzen seemed to hit an absolute wall about three games in, only to recover in terms of his "wind" and "pace of game" late in the Stanley Cup Finals--when you've got a concussion, part of an athlete's recovery is to see what kind of physical exertion he can maintain without a recurrence of symptoms, and when he can, say, ride a stationary bike for thirty minutes without headaches or nausea for a few days, you ramp that up. In Franzen's case, the first day he skated was very likely the first day he could resume any physical activity whatsoever.