Brain injury victims can seem OK, symptoms delayed

Mar 20, 2009
Graphic shows how an epidural hematoma forms between the brain and the skull

(AP) -- At first, Natasha Richardson said she felt fine after she took a spill on a Canadian ski slope. But that's not unusual for people who suffer traumatic head injuries like the one that killed the actress.

Doctors say sometimes patients with injuries have what's called a "lucid interval" where they act fine for an hour or more as the brain slowly, silently swells or bleeds. Later, back at her hotel, Richardson fell ill, complained of a , and was taken to a hospital. She died Wednesday in New York.

An autopsy Thursday showed that the 45-year-old actress hit her head, which caused bleeding between the skull and the brain's covering, resulting in what's called an . It's a type of injury often caused by a skull fracture.

Because of that lucid interval, doctors always tell patients who seem OK after a to have someone keep a close eye on them, in case symptoms emerge.

Symptoms - headache; loss of consciousness; vomiting; problems seeing, speaking or moving; confusion; drainage of a clear fluid from the nose or mouth - appear after enough pressure builds in the skull. By then it's an emergency.

"Once you have more swelling, it causes more trauma which causes more swelling," said Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center in the nation's capital. "It's a vicious cycle because everything's inside a closed space."

Pressure can force the brain downward to press on the brain stem that controls breathing and other vital functions, causing coma or death. Frequently, surgeons cut off a portion of the skull to give the brain room to swell. Or they drain the blood and remove clots that formed.

"This is a very treatable condition if you're aware of what the problem is and the patient is quickly transferred to a hospital," said Dr. Keith Siller of New York University Langone Medical Center. "But there is very little time to correct this."

Details of Richardson's treatment have not been disclosed.

A CT scan can detect bleeding, bruising or the beginning of swelling after an injury. The challenge is for patients to know whether to seek one.

"If there's any question in your mind whatsoever, you get a head CT," Aulisi advised. "It's the best 20 seconds you ever spent in your life."

©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Explore further: National initiative shows multisystem approaches to reduce diabetes disparities

add to favorites email to friend print save as pdf

Related Stories

'Talk and die' syndrome not common, doctor says

Mar 19, 2009

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 ...

Pill ingredient could prevent brain damage after head injury

Apr 30, 2008

A common component of the contraceptive pill (progesterone) could improve the neurologic outcome for patients with severe head injuries, according to a study published in BioMed Central’s open access journal Critical Ca ...

Traumatic aortic injury -- New Review

Oct 15, 2008

A blunt traumatic injury to the aorta, the body's main artery, is one of the leading causes of death following a vehicle crash. If it is not treated rapidly, the patient is at serious risk for artery rupture, which is nearly ...

Recommended for you

Blending faith and science to combat obesity

3 hours ago

Science and religion may seem like uneasy partners at times, but when it comes to promoting healthy lifestyles, one UConn Health researcher has shown they can be an effective combination.

Research project puts stroke patients back on their feet

4 hours ago

Finding the will to exercise routinely can be challenging enough for most people, but a stroke presents even more obstacles. Yet aerobic exercise may be crucial for recovery and reducing the risk of another ...

Air quality and unconventional oil and gas sites

7 hours ago

Research suggesting air pollutants released by unconventional oil and gas production are well over recommended levels in the US is published today in the open access journal Environmental Health. High levels of benzene, hydrog ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.