Subscription Center
Mar 19, 2009 06:15 PM | 7
Actress Natasha Richardson, who died yesterday after a seemingly minor fall on a Canadian ski slope, was killed by blunt trauma to her head, a coroner said today.
Richardson, 45, died of an epidural hematoma, a bleed between the skull and the dura, the lining that covers the brain, New York's medical examiner ruled. Richardson was flown to New York, where she and her husband Liam Neeson, 56, have a home, after Monday's fall. Her death was ruled an accident.
“It can bleed profoundly, causing a clot that expands between the skull and the dura, and you get pressure on the brain,” David Langer, director of cerebrovascular neurosurgery at St. Luke's-Roosevelt Hospital in Manhattan, told the New York Times. “It can be quite dramatic. It’s one of the most acute neurological emergencies. It’s one of the few times where it’s life or death, where you can truly save somebody’s life, or they die if you don’t get to them.”
Richardson was walking and talking after she fell, but developed a pounding headache soon afterwards. Our Ask the Experts Q&A on talk-and-die syndrome explains more about this mystifying phenomenon.
Image of human brain © iStockphoto/Vasiliy Yakobchuk
Tags:
talk and die syndrome,
brain,
brain bleed
More News Blog:
Next: Shell oil company bails on most alternative energy research
Previous: Link between body clock and metabolism may help fight obesity, aging and more
See what we're tweeting about
FlyingTrilobite Tomorrow's Globe shocker: Rob Ford is Vinz Clortho, Keymaster to Gozer. Plans to unleash Destructor/Marshmallow Man upon downtown.
BecCrew Dragon Island Blue is taking over my life
docfreeride Plus side of commencement: I leave so early no one expects me to prepare breakfast before I depart. When I return, however ... #LateLunch
Deadline: Jul 25 2013
Reward: Varies
This challenge provides an opportunity for Solvers to build a web-based or mobile “app” to explore data relationships in scholarly conte
Deadline: Jul 15 2013
Reward: $5,000 USD
SciBX: Science-Business eXchange, a joint publication from the makers
Powered By: 
YES! Send me a free issue of Scientific American with no obligation to continue the subscription. If I like it, I will be billed for the one-year subscription.
7 Comments
Add Comment*Its one of the few times where its life or death, where you can truly save somebodys life, or they die if you dont get to them.
Reply | Report Abuse | Link to thisRichardson was walking and talking after she fell, but developed a pounding headache soon afterwards. *
So, what should someone have done ?
*It’s one of the few times where it’s life or death, where you can truly save somebody’s life, or they die if you don’t get to them.”
Reply | Report Abuse | Link to thisRichardson was walking and talking after she fell, but developed a pounding headache soon afterwards. *
So, what should someone have done ?
An epidural bleed is caused by an injury to an artery, the most common artery injured is the middle meningeal. This is a high pressure event. The epidural clot expands and compresses the brain eventually leading to herniation of brain tissue thru the tentorum. Only 1/3 of these injuries present classically with head injury, loss of conciousness, lucid period, focal neurologic findings and loss of conciousness. Diagnosis is dependent on level of suspicion, verified by CT without contrast, and emergent evacuation of the clot thru burr holes. The lucid period frequently lulls people into expectant management (watching).
Reply | Report Abuse | Link to thisWas she evaluated in an ER in Canada? A CT scan would be the first thing done in an ER in the US. Does the socialized medical care in Canada affect decisions to do a head CT?
Reply | Report Abuse | Link to thisAs far as I know the decision to have a CT scan in Canada does not have anything to do with our universal health care system. We get treated as needed when we go to a hospital. From the news reports I have heard, she refused intitial treatement and the first ambulance on the scene was turned away. She was taken to hospital at least an hour after that. If she subsequently had a CT scan at the hospital I can't say, but it may have been too late at that stage.
Reply | Report Abuse | Link to thisIt's unclear. Was a CT available at that hospital? How did they stabilize her before transferring her to another hospital? It may have been too late.
Reply | Report Abuse | Link to thisIn Toronto, there's only one hospital with a neurosurgical unit. In Montreal, it may be the same. She was injured about 80 miles from Montreal. The small local hospital there certainly would not have a neurosurgical unit. Some general surgeons may have some training in and capable of drilling a Burr hole in an emergency situation.
Reply | Report Abuse | Link to thisThe definitive treatment she needed was to have a Burr hole done ASAP. Any other "stabilization" was just a waste of time. If she went to the local hospital initially, another 30-60 min. would be wasted before she was transferred to Montreal, by that time the game was over.