The Significance of a Bump on the Head

Nancy Harris Bonk Health Guide
  • Natasha Richardson, talented actress and mother of two, was skiing in Canada with her family last week when her life was cut short by a mild traumatic brain injury (TBI). She was on a beginners slope when she hit her head. Within 48 hours she was dead.

     

    Ms. Richardson initially said she felt fine and did not display any signs of a brain injury or feel ill. The resort followed emergency protocol, escorting Richardson back to her hotel to make sure she was ok and again recommend she see a doctor, which she refused. Although no one is quite sure whether or not she lost consciousness, an hour later she started to feel poorly and developed a headache. She was then taken to Centre Hospitalier Laurentien, in Sainte-Agathe-des-Monts, 25 miles from the ski area. Soon after, she was transferred to Hôpital du Sacré-Coeur, a trauma center 50 miles away in Montreal. Her family then transferred her to Lenox Hill Hospital in New York City so they could be with her. Her condition worsened, and she died Wednesday, March 18th, at 7:26 p.m.

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    Ms. Richardson died from an epidural hematoma. This may occur from a blow to the head. Blood pools between the skull and the dura mater, or thick lining of the brain. When this type of injury is treated early and aggressively, people usually have a good prognosis. Immediate medical care after this type of injury is important because, if treated early and aggressively, the outcome is usually positive.

    "It is the most feared, treatable problem in neurosurgery" said Gail Rosseau, chief of surgery at the Neurologic and Orthopedic Hospital of Chicago. "These are the patients who 'talk and die.' "3

     

    "There is no such thing as a mild head injury. It's a misnomer," said Vani Rao, director of the Brain Injury Program at Johns Hopkins Bayview Medical Center and a neuropsychiatrist. "Go to the emergency room immediately and get a complete evaluation."2

    Headache from blunt trauma, falls, motor vehicle accidents and/or sports accidents should never be ignored. Sometimes, as in Ms. Richardson's case, the headache doesn't start right away, but by the time it does, the damage has already begun.

     

    Some signs of TBI are:

    • head pain
    • any loss of consciousness
    • amnesia
    • confusion
    • lightheadedness / dizziness
    • blurred vision or tired eyes
    • ringing in the ears
    • bad taste in the mouth
    • fatigue or lethargy
    • a change in sleep patterns
    • behavioral or mood changes
    • trouble with memory, concentration, attention, or thinking

    A person with a moderate or severe TBI may show these same symptoms, but may also have:

    • a headache that gets worse or does not go away
    • repeated vomiting or nausea
    • convulsions or seizures
    • an inability to awaken from sleep
    • dilation of one or both pupils of the eyes
    • slurred speech
    • weakness or numbness in the extremities
    • loss of coordination
    • increased confusion, restlessness, or agitation.

    If you have any blow to the head and experience any of these symptoms, seek medical attention right away. A CT scan will show if there physical problems such as an epidural hematoma. 

  • Post-concussion syndrome is another result of some TBIs. These symptoms can include:

    • chronic head pain
    • concentration and short term memory issues
    • ringing in the ears
    • depression

    There is no "treatment" per se for this syndrome, just managing the symptoms with lifesytle changes and medication as needed.  Dr. Krusz answers a question in our Ask the Clinician section on post-concussion syndrome HERE.

     

    Ms. Richardson was the wife of actor Liam Neeson and the daughter of famed actress Vanessa Redgrave who sat at her daughter's bedside and sang the lullaby Edelweiss (from The Sound of Music) to her. Ms. Richardson's career spanned both the movie screen and the Broadway stage. The lights on Broadway were dimmed in her memory. Actor Patrick Swayze spoke of working with her and of her death:

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    "It is such a great loss to this community to lose an actress and person such as Natasha. Gifts like her don't come along very often. It's a rare thing in this industry to have someone with so much talent, beauty, and dedication and yet is imbued with such humility... I know for me and many other people, the world will be a different place without her. My heart goes out to Liam and his two boys, but I'm sure that Natasha's light is shining down on them."

    In Ohio, the life of a seven-year-old girl has been saved by the coverage of Ms. Richardson's death. Morgan McCracken was hit in the head by a baseball. She showed no symptoms beyond a bump on her head that went down when ice was applied to it. She went to school, and things went on as usual. Two days later, she complained of a headache. Her parents called her pediatrician, who told them to take her to the emergency room. A CT scan revealed an epidural hematoma, the same injury as Richardson. She was taken by helicopter to Rainbow Babies and Children's Hospital in Cleveland, where she went into the operating room within three minutes of her arrival. She is expected to fully recover.

     

    Ms. Richardson's death was a horrible, sudden loss for her family and friends. It is unfortunate that she died under these circumstances, hopefully it will make people think twice if they hit their head or have any unexplained headache.

     

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     Sources: 

    © Nancy Bonk, 2009

  • Last updated 3/28/09.

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Published On: March 24, 2009