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Natasha Richardson Dies After Brain Injury

Brain Experts Weigh In on Natasha Richardson's Head Injuries From a Skiing Accident
By
WebMD Health News
Reviewed by Louise Chang, MD

March 18, 2009 -- Actress Natasha Richardson, 45, has died in the wake of head injuries she sustained in a fall at a Canadian ski resort.

Media reports have posted a statement from Richardson's family that reads, "Liam Neeson [Richardson's husband], his sons, and the entire family are shocked and devastated by the tragic death of their beloved Natasha. They are profoundly grateful for the support, love, and prayers of everyone, and ask for privacy during this very difficult time."

According to media reports, Richardson's accident, which happened Monday on a beginner slope at Canada's Mont Tremblant ski resort, didn't result in immediate, obvious harm. Richardson is said to have felt fine until an hour or so after the fall, when she developed a headache.

At that point, she went to a hospital near the Canadian ski resort where she was staying and was later transferred to a New York hospital. Richardson and Neeson have two sons.

WebMD talked with three brain experts, none of whom treated Richardson, about her brain injury. The interviews were conducted before Richardson's death was announced.

What would account for a delayed reaction after a fall?

There are at least two possibilities.

First, a pre-existing condition could be exacerbated by the head injury, says Jordan Grafman, chief of the cognitive neuroscience section at the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health. It's not known if Richardson had any pre-existing brain conditions.

Second, a fall could jar the brain inside the skull.

"If the brain moved quickly, it could cause contusions [and] bleeding, and the bleeding could lead to increased intracranial pressure, and that could have severe consequences," Grafman tells WebMD.

That bleeding may take time to cause obvious problems.

"Sometimes, the bleeding and the increase in pressure are delayed," Grafman tells WebMD.

Neurologist Russell Packard, MD, agrees.

"You could get what's called a subdural hematoma -- the injury starts with some slow bleeding and so you seem fine at first, and then, within an hour or two hours ... the start of a headache," Packard tells WebMD.

Packard is the former head of the headache and head injury clinics at Texas Tech and the University of North Texas. He is now in private practice in Palestine, Texas. He's a fellow of the American Academy of Neurology and the American College of Physicians.

A hematoma is a blood clot that's growing, says Jill Bolte Taylor, PhD, a brain scientist who had a stroke at age 37 and wrote a book -- My Stroke of Insight -- about it.

"The problem with any kind of blood clot is that you have a fixed and rigid size of the bone. And, so if you've got blood accumulating somewhere, getting bigger and bigger, it has to push against whatever else is in there, which stunts and traumatizes the cells so that they can't function," Taylor tells WebMD.

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