At first, Natasha Richardson felt fine after she took a spill on a Canadian ski slope. But that's not unusual for people who suffer traumatic head injuries like the one that killed the actress.
Doctors say sometimes patients with brain injuries have what's called a "lucid interval" where they act fine for an hour or more as the brain slowly, silenty swells or bleeds. Because of that interval, doctors tell patients who seem OK to have someone keep an eye on them, in case symptoms emerge.
Symptoms -- headache; loss of consciousness; vomiting; problems seeing, speaking or moving; confusion; drainage of a clear fluid from the nose or mouth -- appear after pressure builds in the skull. By then it's an emergency. "Once you have more swelling, it causes more trauma which causes more swelling," said Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center. "It's a vicious cycle because everything's inside a closed space."
Pressure can force the brain to press on the brain stem that controls breathing and other vital functions, causing coma or death. Frequently, surgeons cut off a portion of the skull to give the brain room to swell.
"This is a very treatable condition if you're aware of what the problem is," said Dr. Keith Siller of New York University Langone Medical Center. "But there is very little time to correct this."
Aulisi advised that if you have any question, have a CT scan. "It's the best 20 seconds you ever spent in your life."
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