Natasha Richardson's condition likely due to delayed bleeding

[n2doc]

11:19 AM, March 18, 2009
The head injury Natasha Richardson suffered in a skiing accident Tuesday produced what is often called a "walk and die," syndrome, which is usually due to delayed bleeding from an artery in the brain, said Dr. Christopher Giza, a neurologist at the UCLA Brain Injury Research Center. In such cases, the patients, like Richardson, appear normal immediately after the injury, walking and talking as though nothing happened. But symptoms can develop within an hour, causing the patients first to suffer impaired speech and vision and then to fall into a coma.

She most likely suffered from an epidural hematoma, in which bleeding occurs from an artery in the brain. Because blood in arteries is under high pressure, it can accumulate rapidly in the organ, pushing the brain to one side and leaking down into the brainstem, where it can "cause a change in mental status, the onset of a coma or, in severe cases, kill the person," Giza said. "In general, to have this kind of hemorrhage, you have to experience a significant amount of force."

Such injuries are not common, "but they do occur, even in patients that have been evaluated by a CT scan," said Dr. Keith Black, a neurosurgeon at Cedars-Sinai Medical Center. "That's why, when a person has a head injury, we like to observe them for 24 hours to make sure no delayed bleeding occurs."

When a patient like Richardson develops problems, the first thing physicians do is put them on a respirator to increase oxygen flow to the brain and heart. The respiration rate is typically set high to remove carbon dioxide, a gas that increases swelling. Physicians also give the patient diuretics to remove fluids and steroids to minimize or reduce swelling.

more:

http://latimesblogs.latimes.com/booster_shots/2009/03/richardsons-inj.html

[Cha]

1. Thanks for this info, n2doc

Poor thing..I'm really hoping for a miracle. I even had dream last night that Natasha Richardson was okay but that could be my wishful thinking.

[nickyt]

3. You know, Cha, I rarely (ever) use the word "miracle", but I really (really)

need one here, as do you and so many others. I hope she and her family can feel our thoughts and hopes at this time (though they are probably just - crazy right now)(been there, you know?) - the human body and brain can do amazing things..well, I'm "wishing" with you, and won't give up hope "until further notice"...

[Cha]

4. That's sweet and good to hear..

thank you, nickyt.:)

Sometimes, we just really feel for certain people we don't even know.

[XemaSab]

2. That happened to my uncle

Motorcycle crash at 2 in the afternoon, followed by doctor's visit to repair broken elbow.

Seizure at 2 am followed by a FAST trip to the ER in the family car with a police escort.

Lengthy brain surgery where the surgeon initially opened up the wrong side of his head due to lack of time for an MRI.

2 months in a coma.

Cancellation of involuntary trip to Vietnam.

After two months, my mom was visiting with him and he said "My elbow hurts."

He's now married to a woman who looks like Laura Dern, has a kid in the Coast Guard and one at Berkeley, and he's got an EPIC spread in BC.

Very little in the way of long-term issues.

:)

But yeah, poor woman, poor family. :(

[Warpy]

6. Neurology is where I saw the miracles.

I hope she gets one like your uncle did.

[XemaSab]

10. It was such a fine thread of events between death, disability,

and a 100% complete recovery.

Oh, and I should say, the recovery process was long... I think he was in the hospital for 6 months after he woke up. :(

[tanyev]

5. Wow. I keep thinking about a pretty hard knock on the head I got several years ago.

I didn't feel like I needed to go to a doctor. Thank goodness it was OK.

[Control-Z]

7. This kind of condition is

frightening and confusing. My daughter's father fell and hit his head. He was found hours later. Surgery was performed to ease the bleeding and swelling. He never came out of the coma, and was left in a vegetative state.

But it really is not as simple as removing life support. In his case, he continued to breath after. But the fact that a feeding tube had been put in place made all the difference in the world. Removing a feeding tube is something that is not done without a lot of consideration, ethics hearings, waiting. Some consider removing it akin to putting a bullet through the patient's heart. That was the case with my daughter's father. So he was left in a vegetative state, with no hope for recovery, but with a feeding tube in place - until he died naturally 3 years later.

It was a nightmare that has changed my daughter permanently. I still don't know how to help her recover. So sad. So helpless.

I feel so much pain for Natasha Richardson and her family. If her condition is hopeless, I hope they don't have to go through the long extended ordeal we did.

edit: for clarity

[LSparkle]

8. I've been unusually moved by this story ...

I was never that big a fan of hers (although, now that I see all the
films she's been in, I've seen quite a few of them) but this really
shook me. I admit I'm a fan of Liam Neeson and maybe it's the fact
she's his wife that has me hoping and praying for the best for them
all ... and looking everywhere (web, TV) for the latest updates on
her condition. As several above have noted, all we can hope for is
a miracle ...

[dddem]

9. I feel the same

I've always enjoyed her performances, I am a huge fan of her husband, but I think what has touched me is the fact that she has two boys who don't seem ready to have to finish growing up without their mom. Ms. Richardson and her family are in my prayers.

[Nordmadr]

11. Less than 6 months ago

a friend of mine fell from his roof while making repairs. Landed on his feet, but rolled back, striking his head on a sidewalk. He never woke up. Everything down to his bone marrow went to organ donations. I still can't believe he's gone.

Nordmadr

[DarbyUSMC]

12. I guess all hospitals don't observe head injuries for 24 hours.

Or maybe it is where the head is injured. I did have a CT Scan about an hour after impact with the cement floor under my thin carpet but I was out of the ER within 2 hours. I still have a dent in my head and the vision in that one eye changed. This happened on Sep 2 of 06.

My heart sinks thinking of Natasha and all who love her.

[H2O Man]

13. It happened

to a friend decades ago after a boxing match.

[CreekDog]

14. A teenager died in San Jose this same way

he had been playing a dangerous game of riding on the hood of a car with his friends but he fell off and hit his head. However, he said he felt okay and went home. He died not long after. Very sad.