Yesterday, March 19, 2009, actress Natasha Richardson died of a traumatic brain injury after a “minor fall” while skiing. It was reported that she initially felt OK, and sent away an ambulance that had been called to the scene. She later complained of a headache, and rapidly deteriorated after that. Although we don’t know the specific diagnosis, the most likely culprit is an epidural hematoma (or blood clot inside the skull but outside the brain). Epidural hematomas are caused by a blow to the side of the head. The skull bone that covers the major artery (middle meningeal artery) to the brain surface is relatively weak and prone to injury. Patients may initially be asymptomatic or have a brief loss of consciousness. After a so-called “lucid period,” when bleeding inside the brain starts to expand, patients will complain of headache, and with continued expansion, loss of consciousness or other abnormalities. Treatment is surgical with removal of the blood clot and repair of the artery.
Traumatic head injury