Natasha Richardson
Image: WIKIMEDIA COMMONS/KHEDARA
-
The Best Science Writing Online 2012
Showcasing more than fifty of the most provocative, original, and significant online essays from 2011, The Best Science Writing Online 2012 will change the way...
Read More »
Last night, British-born actress Natasha Richardson, 45, was rushed from Montreal to New York City in critical condition after a seemingly minor fall on a Quebec ski slope apparently led to bleeding in her brain.
Richardson, who won a Tony for her role in the Broadway play Cabaret and has also starred in a string of films including The Parent Trap and Maid in Manhattan, is the daughter of actress Vanessa Redgrave and the wife of actor Liam Neeson, 56, with whom she has two sons, ages 12 and 13. She was reportedly taking a skiing lesson on a beginner slope at the Mont Tremblant resort some 80 miles (130 kilometers) northwest of Montreal when she took a spill.
"It was a normal fall," Lyne Lortie, a Mont Tremblant spokesperson told The New York Times, "She didn't show any signs of injury; she was talking and she seemed all right."
Still, her instructor summoned the ski patrol to transport her to the bottom of the hill in accordance with the resort's safety policies. Richardson reportedly refused medical care when an ambulance arrived and went back to her hotel room. About an hour later, however, Lortie said that Richardson complained of a severe headache; she was rushed by ambulance to Hôpital Sacré-Coeur in Montreal, where Neeson met her after flying in from Toronto where he was filming a movie. The actress was then flown by private jet to Lenox Hill Hospital in Manhattan, where she and Neeson have an apartment on the Upper West Side.
The family had not issued a statement at deadline and no reports on her condition had been confirmed. However, some media outlets, citing anonymous sources, claim that the actress had been on life support but was removed from it today and was not expected to survive. "It's so sad. Vanessa, her sister Lynn, everybody is gathering in New York to say goodbye," a "close friend" of the family told London's Daily Mail. "No one can believe what has happened, that this once vibrant woman, full of love, of life, is lying there brain dead."
The tragic story, if confirmed, is a reminder that even minor blows to the head can lead to devastating bleeding that can cause strokes or otherwise damage brain tissue. One possibility, sometimes called "talk and die" syndrome, is that the actress had delayed bleeding between her skull and her brain stem, which sits at the top of the spinal cord and regulates consciousness, breathing, and the heart and connects the brain to many of the body's sensory and motor nerves. Another possibility is that there was a tear in the inner lining of her arteries, causing blood clots. To find out more about Richardson's potential injury, we spoke with neurosurgeon Keith Black, chairman of the Department of Neurosurgery at Cedars-Sinai Medical Center in Los Angeles.
[An edited transcript of the interview follows.]
Based on Richardson's symptoms, what kind of injury do you think she suffered?
The possibilities range from what we call an arterial dissection to a preexisting condition that might have been triggered by the event. An arterial dissection is where patients have a very mild injury tear the inner lining of the arteries of the neck, either the carotid or vertebral arteries, and that can occur with even minor trauma that one may not believe to be significant. That tearing in the artery can cause clotting, which can set up a stroke (an interruption of the brain's blood supply caused by a blockage or a rupture of a blood vessel). If that clot is in the vertebral artery system, it can cause a stroke in the brain stem, which can be devastating.
The other possibility is delayed bleeding in the brain. That can be from either a tear in a vein or an artery in the brain tissue itself, and that can be either an epidural hematoma (between the skull and the dura, the membrane that surrounds the brain) or a subdural hematoma (between the dura and the brain).
Another possibility is that she had a condition that predisposed her to having a more catastrophic event. This could be an abnormality in how fast her blood clots after a bleed. Or if she's been on any aspirin, blood thinners, or, supplements like omega-3 fish oil, that can make things worse. The other thing one has to worry about is whether she had a vascular abnormality in the brain like an arteriovenous malformation (an abnormal connection between high-pressure arteries and low-pressure veins). If an AVM tears one can get a more significant bleed.
I think the two most likely conditions would either be the arterial dissection in the neck or the delayed bleeding within the brain itself.
See what we're tweeting about
13 Comments
Add CommentI hope she gets well by the way.
Reply | Report Abuse | Link to thisshe died.
Reply | Report Abuse | Link to thisDeath is not suffered by the dead but, rather, the living. My heart goes out to Mr. Neeson, their children, and all of her family and friends. This is a horrible loss to them. For them: please know that you are not alone.
Reply | Report Abuse | Link to thisNow that we know the outcome there will be a lot of interest in whether her death could have been prevented. Was there a CT scan done before transfer to Montreal? Was there a neurosurgeon available in the community hospital? Should the transport to Montreal have been done by Helicopter? At Lake Tahoe, where I sk regularly, it is common for injured skiers to be airlifted to the medical center at Reno, Nevada, which is about 35 miles away. Why was this not done for Ms. Richardson?
Reply | Report Abuse | Link to this"Or if she's been on...supplements like omega-3 fish oil, that can make things worse." Does anyone know why that would make things worse? I thought omega-3 fish oil was beneficial for the brain and maintaining overall health.
Reply | Report Abuse | Link to thisDespite their many beneficial properties, omega-3 fatty acids, like aspirin, are also natural blood thinners, reducing the "stickiness" of blood cells (called platelet aggregation), which can lead to such complications as blood clots and stroke.
Reply | Report Abuse | Link to thisSki helmets should be mandatory. This case os a sad example of why.
Reply | Report Abuse | Link to thisHey,
Reply | Report Abuse | Link to thisThere is no confirmation that she is dead. What if she just had a bad concussion and the hospital wanted to keep here there over night for observation and to make sure she doesn't have memory loss....Or she could be in a coma.
A closed head injury ,without the loss of consciousness, generally does not require admission to a hospital or a trip to the ER, after an initial evaluation and physical exam (inclusive of a neuro check and vital signs).
Reply | Report Abuse | Link to thisIt is apparant from the article that she refused medical care when the ambulance arrived. This pre-hospital care would have probably included a neuro check, vital signs, and possibly other diagnostics.
However, if she did lose consciousness, then a trip to the ER was adviseable. The article mentions that she didn't show any signs of injury and implies that she didn't lose consciousness.
What caused her death? Blunt head trauma resulted in a head concussion that resulted in bleeding (from some source) within the cranium.
Demise, after a short period of lucidity, can proceed rapidly due to intracranial bleeding.
My condolonces to the Richardson family, her husband, Liam Neeson, and the Redgrave family.
Natasha Richardson was an wonderful and skilled actress and a wonderful person.
I heard that somebody I'd met, the girlfriend of someone I knew, had died very young. She had a defective blood vessel in her brain I think. The only young person I knew who just ... died.
Reply | Report Abuse | Link to thisMy dad died of a head injury similar to Natasha Richardson but in my dad's case; a CT Scan was not given at the time of his accident so they could have done surgery earlier and possibly saved him. My heart goes out to Natasha's family. I know well of their heartache as I had to go through the same thing in 2000. My dad was only 60 years old.
Reply | Report Abuse | Link to thisWhat did her post mortem exam show? I assume one was done. I think this is a classic example of why people should be checked by a reliable physician and if a cat scan was not done then she should have been observed overnight. EM, emergency physician
Reply | Report Abuse | Link to thisShe should have been checked by a physician and either had a cat scan or be admitted for observation overnight. What did her post mortem exam show? I have seen many people since this incident occurred and there are several other similar type incidents. I am anexperienced emergency physician with over 30 years of experience.
Reply | Report Abuse | Link to this