March 18, 2009 — Actress Natasha Richardson is in a New York hospital after
a skiing accident that reportedly caused serious brain injury.
The exact nature of Richardson’s injury hasn’t been made public. But
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
.
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, 45,
is married to actor Liam Neeson; the couple have two sons.
How could a seemingly minor fall lead to a serious brain injury? For
answers, WebMD talked wit
experts, none of whom are treating Richardson.
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
, 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 –
— about it. [Read more of
Taylor's comments in
.]
“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.
“The first thing that the body
does anywhere there’s trauma is send more blood in order to bring the immune
system, so the immune system can make an assessment and clean up what it needs
to clean up. The same thing is true inside of the brain. So now, not only is
there a bleeding into the brain region, but more blood is wanting to get there
in order to bring the immune system in order to clean it up,” Taylor
explains.
“At this point, the brain’s in
trauma and as long as the cells are essentially swimming in a pool of blood,
they cannot perform their function. So they can ask her to do things that she
probably would be able to do once the swelling goes down.”

webmd.com

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