'Talk and die' syndrome not common, doctor says

Mar 19, 2009 By Ridgely Ochs

In "talk and die" syndrome, people can have what seems to be a mild blow to the head appear perfectly lucid and then within hours lapse into a coma -- which is what reportedly happened to actress Natasha Richardson after she fell on a Canadian ski slope Monday.

"It is not a very common occurrence," Dr. Steven Flanagan, medical director of the Rusk Institute of Rehabilitation Medicine at New York University Langone Medical Center, said Wednesday. "A patient comes into the emergency room talking and then rapidly deteriorates" as pools and puts pressure on tissue.

Flanagan and other doctors speculated that Richardson could have had an epidural hematoma.

Usually caused by a trauma such as a fall, blood builds up between the cover of the brain, called the dura, and the skull. Blood trapped inside the "closed box" of the skull can compress , which can cause pressure on vital functions, said Dr. Henry Woo, associate professor of and radiology at Stony Brook University Medical Center.

A CT scan is the best way to diagnose a , said Dr. Ashesh Mehta, a neurosurgeon at North Shore-Long Island Jewish Health System. Like other doctors, he said anyone who has had a blow to the head should be watched for changes in his or her condition.

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(c) 2009, Newsday.

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