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College Hockey:
BU Doctor On Exter Injuries; HEA Completes Review Of Incident

— Merrimack goaltender Joe Exter remained in serious condition Tuedsay at Boston’s Beth Israel Deaconess Medical Center Tuesday with multiple fractures sustained in a collision during last Friday’s Hockey East quarterfinal game at Boston College.

According to hospital officials, there is no change in Exter’s condition, and nothing further is expected before Wednesday morning.

The injury occurred when Exter dove head-first for a puck, colliding with BC’s Patrick Eaves. Eaves’ left knee struck Exter in the left temple, knocking the goaltender’s helmet off before his head slammed against the ice.

Early reports indicated that Exter sustained two fractures of his skull. And according to Dr. Joe Ordia, Professor of Neurosurgery at Boston University Medical Center, that diagnosis is consistent with visual symptoms immediately after the collision.

Exter fell unconscious with bleeding from his ears, then stopped breathing and started convulsing on the Conte Forum ice. According to Dr. Ordia, these are symptoms consistent with a particular type of skull fracture.

“The symptoms suggest that there has been a fracture in the base of the skull,” said Ordia. “With that type of fracture there can be bleeding from the ears and around the eyes.”

Dr. Ordia noted that with that type of injury, there is a chance of damage to the brain stem.

“The brain stem is the portion of the brain that controls vital functions such as consciousness, wakefulness, blood pressure, and respiration,” said Dr. Ordia, noting that this may be what led Boston College’s medical staff to insert a breathing tube.

According to reports, Exter has been kept in a medically-induced — or barbiturate — coma since the accident, a method used to control brain pressure.

“If the brain pressure is high, a lot of it is transmitted to the brain stem,” he said. “If the brain pressure rises and is not controlled, there is a secondary injury to the brain stem, making it more difficult to recover from the damage.”

Dr. Ordia noted that the secondary damage resulting from brain pressure can range from reduced blood flow to irreversible brain damage and death. He noted, though, that keeping the brain pressure under control makes full recovery more likely, “particularly in younger people.”

Dr. Ordia also noted that doctors will likely be monitoring Exter’s brain pressure closely through a tube inserted through surgery, and not until the pressure is reduced would doctors bring Exter from the coma. He did not suggest that remaining in the coma poses any more or less danger than ordinary to a patient in Exter’s case, but noted that common complications with a prolonged coma include pneumonia, urinary infections, and blood clots in the lungs.

He also noted that one of the most important factors to healing a brain injury is nutrition, typically by feeding the patient through a tube into his or her stomach.

Words of prayer and support continue to filter to the Merrimack hockey program from around the world. A prayer board set up on the Merrimack Web site had nearly 200 messages on Tuesday, and message boards on USCHO.com also filled with prayers of support.

According to Merrimack officials, the college will be arranging an on-campus prayer service next week when students return from spring break.

Please check back to USCHO.com for more information as it becomes available.


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