Richardson`s death shows need to protect brain
Actress Natasha Richardson`s accidental death from what appeared at first to be a mild head injury serves as a reminder of the delicate nature of the brain, experts said on Thursday.
Brain injuries that cause the loss of consciousness or other symptoms like vomiting or headache are much more typical, but in some cases the injury is not immediately apparent.
"What occurs sometimes is a person will get up looking and feeling fine and have what we call a lucid period right after the injury, not unlike what was reported in the media for Natasha Richardson," said Dr. Felise Zollman, a brain injury expert at the Rehabilitation Institute of Chicago.
According the U.S. Centers for Disease Control and Prevention, at least 1.4 million people in the United States suffer a traumatic brain injury each year, 250,000 are admitted to hospital and 50,000 die.
Richardson fell during a private skiing lesson on a beginners` slope in Canada on Monday. She died in New York on Wednesday from a epidural hematoma, bleeding in the brain caused by blunt impact to the head, according to the medical examiner. She was reportedly not wearing a helmet.
Zollman said the fact that Richardson appeared to be in good condition at first is consistent with that type of injury, in which a pocket of blood accumulates in the space between the brain and the skull, often caused by a torn artery.
"As that pocket of bleeding continues to grow, it causes pressure against the brain. When the bleeding begins to expand to the point where it causes enough pressure, the person begins to develop symptoms. They start to develop headache. They don`t feel good. They may throw up. They may lose consciousness."
Zollman said the problem is that the brain is in a fixed space. "There is no room in the skull," she said.
The brain can herniate as pressure forces it down into the space where the spinal cord communicates with the brain, causing death.
Dr. Paul Vespa of the University of California, Los Angeles Medical Center said this type of injury commonly occurs in sports like skiing, skateboarding or cycling.
"The brain initially starts having some small hemorrhaging, but that can get worse very quickly, so it is important to think about prevention," Vespa said in a telephone interview.
Wearing helmets is probably the No. 1 prevention out there for head injury," he said.
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