It doesn't take a neurosurgeon to deduce that a frozen hockey puck moving at 100 mph is a potentially deadly projectile. When Espen Knutsen's deflected slap shot struck Brittanie Cecil in the left temple on March 16, it fractured her skull and bruised her brain on impact. But it didn't kill her. Not on impact, anyway. Brittanie died as a result of an exceptionally uncommon blood clot, caused when her head snapped back violently as she was hit.
After Brittanie was struck, she retained consciousness and was taken by ambulance to Columbus Children's Hospital for observation and to receive stitches for a small gash. In the emergency room she suffered a seizure and was admitted to the hospital. But she recovered quickly, and by the next day she was conscious, communicative and able to walk around in the hospital. She didn't complain of much neck pain or suffer symptoms such as confusion or dizziness that might have served as warning signs. "I think everyone's impression was that she was doing fine," says Franklin County coroner Brad Lewis.
But what Brittanie's doctors didn't know was that she had suffered a tear to her right vertebral artery, which supplies blood to the back of the brain. (The CAT scan performed when Brittanie was in the hospital did not reveal the tear.) The torn artery developed a clot that increased steadily in size, so much so that it inhibited the blood supply to Brittanie's brain. As less and less blood flowed, the clot continued to expand.
On the morning of March 18, Brittanie developed a high fever and lost consciousness. Lewis believes that the swelling became so severe that it compressed the three other main arteries that supply blood to the brain. By the time doctors performed an angiogram that revealed the blocked arteries, they were powerless to reverse the damage. She died at 5:15 p.m., nearly 48 hours after she had been struck and two days shy of her 14th birthday. "This is just an incredibly rare thing," David Milzman, a Georgetown University emergency room doctor and expert on hockey injuries, told The Columbus Dispatch. "I wouldn't have thought of that, and anyone who says they would have is lying."