Actress Died From Clot That Compressed Brain

Natasha Richardson, the British actress who fell during a ski lesson on Monday and later in the day lapsed into a coma, died of a large blood clot compressing her brain, New York City's medical examiner said yesterday.

The bleeding that led to the clot was caused by "blunt impact to the head," according to the official report, which also labeled the death an accident.

The formal name for the condition is "epidural hematoma." It is usually the result of bleeding from arteries torn when the skull is struck hard, often on the temple where the bone is thinnest.

Arterial hemorrhage inside the skull is a potential catastrophe. Each heartbeat pumps blood under high pressure into a confined space, compressing the brain tissue.

"It is the most feared, treatable problem in neurosurgery," said Gail Rosseau, chief of surgery at the Neurologic and Orthopedic Hospital of Chicago. "These are the patients who 'talk and die.' "

If the condition is recognized in time, a surgeon can drill a hole through the skull or cut away a piece of it, remove the clot and relieve the pressure. This often results in complete recovery.

http://www.washingtonpost.com/wp-dyn/content/article/2009/03/19/AR2009031902515.html?hpid=moreheadlines

Damn........

And they are certain the family flew her to NY because they knew she could never be saved in a country with socialized medicine.

Ignoring the fact, of course, that the family already knew she was brain dead before they moved her.

Matches the post mortem.

In Remote areas like Ski Areas which are more ofter than not at least 30 minutes to a emergency hospital where a hole could be drilled.

She probably didn't have a chance once the clot started to form there is a point of no return and that could happen when the patient is still walking and talking. Had she been knocked unconscious that might of saved her life.

I was a Pro ski patroller for five year and head injuries were the most feared because there was nothing much we could do other than immobilize, load and go...

This should highlight not the need for Helmet requirements...but for Ski Patrol to insist on emergency transportation to rule out such an injury. Taking a "wait and see" tact on a head injury can result in deadly consequences.

Had she been transported directly to the Emergency Room and had x-rays the problem would of probably been detected.

The problem is...many patients will refuse interrupting their day with a trip to the ER...they will refuse care and transportation. I saw this numerous times...and many times we pleaded with people to go and warned them that serious consequences could result from even a minor head injury hours later.

Attitudes about Head Injuries while skiing and helmets will no doubt change as a result of this accident.

Blunt force head injuries are nothing to trifle with, them mechanism of the fall or the injury is such that unseen damage could happen...particularly at a Ski hill where even on a Green slope, speeds can be obtained that greatly magnify the forces encountered in a accident.

That the name Natasha RIchardson may become synonymous with what can happen in seemingly mild cases of head trauma, underscoring the need to get checked out.

this case. You are correct that being knocked unconscious probably would have saved her life, you are correct about the helmets, and we should all hope and pray you're correct about attitudes towards head injuries changing because of the accident but I must differ with you on the assumption that she had no chance once the clot started to form. If this young lady would have erred on the side of caution and gone for treatment right away there is a very good chance she would be recovering in a hospital right now.

there was a teen boy on a football team who died after an untreated head injury not long ago.

She refused treatment at first. If she'd gone directly to the ER, perhaps she would not have died. People with head injuries need to be seen but often don't want to. If YOU get a head injury, please get checked out. If someone you are with does, please use your forces of persuasion to get them checked out.

This procedure is actually one of the oldest surgeries in existance... and yes you can do it at home if needed. (You would probably want to go to the hospital afterwords though.)

what did her head hit when she fell? Was it the snow? ice? a ski or ski pole? another skier? They talk about 'blunt impact to her head' - but it would seem that one would need plenty of force exerted to cause the damage they say.

Sometimes, an accident is just an accident. Any fall can cause a serious head injury.

that when I fell one time cycling down a steep hill and losing control I had only a minor concussion. That was before I started wearing a cycling helmet.

I did faint for a little bit afterwards, but I am grateful it wasn't worse. This was in 1976.

I wish she had been wearing a helmut and I wish she had gone to the hospital right away. Of course, that is with 20/20 hindsight.

She did not hit a tree, another person or anything other than the snow. Supposedly the snow was wet and soft. One or both of her sons was there. She was talking and joking afterward.

The resort recommends helmets, but doesn't require them. She chose not to wear one.

The resort staff handled it by the book, brought her down from the mountain by toboggan, called an amublance and tried to convince her to go to the hospital. She refused.

The staff accompanied her to the hotel and stayed with her the entire time, apparently still trying to get her to accept medical treatment. It wasn't until she got the pounding headache that she agreed to go to the hospital, at around 3pm and 2 1/2 hours after the fall.

The resort did everything they could legally. They couldn't force her onto the ambulance unless she was unconscious. She just refused to go until she felt ill. By then, it was too late.

She ran into a tree, didn't she?

people who sustain these kinds of brain injuries are born with certain vascular weaknesses that, later in life, manifest as hematomas and aneurysms and such. Perhaps she had this condition?

He and a work colleague were in a parking lot and while pulling out/away from the parking space at low speed the driver accidently ran over one of those cement blocks. It has happened to me. No biggie. The fellow's head snapped back a bit and that was all. Later he had pain & went to his doctor. Tests revealed he had a small tear and leak, which fortunately was treatable. But who would have thought an incident so commonplace could have been potentially life threatening?

Richardson may have hit her head on the snow on the side of the head where the skull is weaker and not realized the potential for injury. Whether she may have had any additional vulnerability is not known.

Those are actually the worst to fall on. Both me and my girlfriend almost had concussions falling on flat areas. It was a wake-up call for sure.

That's the most hard packed area at any resort.

And by the way, that broken tail bone hurt like hell for a long time.

...my sternum. Ouch. That hurt for 6 months. I couldn't run....and coughing and sneezing....my god.....

I swear the blues and blacks are safer!!! (unless you are in a roped-off area or going through trees......)

He was DWI, very drunk, and crashed. He had zero cuts/bumps when he was taken to the hospital. When they called me (3 hours later) they said he was still drunk because he was slurring his speech and not very responsive.

Turns out he bumped his head really hard during the crash, and his brain was bleeding and swelling. They did emergency surgery to remove a clot 'the size of a peach pit'. They ended up removing a portion of his skull above his left eye so that his swollen brain had room to swell more, if that makes sense. They put that piece of bone in a special freezer and put it back in several months later. They also had to put him into a drug induced come to bring down his intracranial pressure.

He crashed Sunday morning and did surgery 2 days later. He was in neuro ICU the whole time.

How was he after he recovered; or did he recover fully? Did he continue drinking? (It's OK to tell me if you think I'm being too nosy).

but he hadn't told his parents yet. We were young, only 25. As he was laying there near death in the hospital, I had to tell her we were getting divorced. That was horrible and awkward, to say the least. He had been to rehab 3 times in 9 months, and I was done.

He did recover, after many months in a rehab hospital. He was left with the mental capacity of (the docs said) an 11 year old and became easily confused. His mother had to put him in an adult daycare program. I have no idea what he's doing now.

she would have been helicoptered out of the resort and taken directly to Montreal - not waiting almost 6 hours to be in a specialized trauma unit. It might have made the difference between life and death.

This is just a tragedy that I'll never forget.

by going to hospital etc...I think it is something women often do, we get hurt and we think we can brush it off, pain will go away if we ignore it, including want seems like a small bump on the head..we don't like to be seen to whinge and complain.
Natasha Richardson was also someone that didn't like to be "starry", maybe she felt self-concious of her name, when an ambulance was called, that she thought wasn't needed.. It was such a needless death...

refused anesthesia to be back home before we woke up on Christmas day....I never thanked her enough for her courage and sacrifice!

have taken action quicker, or, on the first onset of the headache, take charge with the decision.

I've been aware of traumatic head injuries since my oldest son was born. Whenever he'd hit his head or my youngest, I would monitor them closely and on a couple of occasions gone to the doctors office.

After she refused the first ambulance, her instructor and another resort staff member accompanied her to her room and tried to convince her to go to the hospital. But she felt fine, so refused. It wasn't until she got the pounding headache and felt sick that she let them call an ambulance. By then it was too late. With epidural hematoma you are asymptomatic for an hour or two. Once symptoms begin, you go down fast.

There's only so much room in the skull (it doesn't give) - bleeding in that space causes pressure and eventually impacts the brain. Closed head injuries are terrible because once you have significant symptoms, it's probably too late.

Natasha Richardson had no outward signs of injury; she didn't hit a tree or a rock and felt fine afterward. She didn't think she needed to go to the hospital. Can't blame the first responders or the hospital.

People don't think they are going to die from a fall.

As the hematoma became larger, she started complaining of a headache and probably began experiencing neurological problems. By the time she got to the hospital 6 hours later, the hematoma had done irreversible damage to her brain. So very sad.

For instance, one day I was sitting on the railing, I have fallen back wards, hit my head hard, didn't seek any medical attention, and nothing happened.
Most people don't think they will die from hitting head in a fall.
And most people don't die from it.

The human skull is able to withstand impact up to 15 mph - or as fast as a person can run. That's why falling backwards and hitting your head while stationary didn't cause serious injury.

When the head meets an immovable object (in this case the ground) while moving faster than 15 mph it should be taken very seriously. Even though Richardson was on a beginning bunny slope, she was probably traveling 20-30 mph.

a certain height. At the very least the head is moving at some speed while you are falling.

Falling off a desk - 3.5 feet - results in a speed at impact of 10 mph. Falling off a stepladder - 7.5 feet - results in a speed at impact of 15 mph. Falling off the roof of a one story building - 13.5 feet - results in a speed at impact of 20 mph. Falling off a 2 story building - 20.5 feet - results in a speed at impact of 25 mph.

So if Natasha Richardson was traveling 25 mph and struck her head on the ground, she might as well have fallen off a two story building. If she had known this information maybe she would have sought care immediately.

Everyone needs to know this.

a couple of years ago in the driveway.

Slipped on a patch of ice and fell backwards with a seemingly slow motion collision of my head and the pavement. I didn't worry to much about it and well nothing happened because of the fall. Still makes you think.

I had hit my head hard on a pavement and it really hurt. I was also told I fell from my crib as a baby, hit my head and had a black eye afterwards. I guess it depends on where you hit your head.

Head & facial wounds bleed a LOT, and force people to seek medical attention..once there, doctors are more likely to look for the serious stuff going on inside the skull..

When my boys were small, they always complained when they fell and I would take them to the ER..