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Brain Hemorrhage Might Explain Natasha Richardson's Death
Date:3/18/2009

by ambulance to a nearby hospital, then transferred to Hopital du Sacre-Coeur de Montreal and then flown Tuesday afternoon to New York City, where she reportedly received care at Lenox Hill Hospital before passing away on Wednesday.

News reports had suggested that Richardson's condition had been extremely grave.

"We don't know for sure what transpired, but it does sound as though she could have had an expanding hemorrhage between her brain and her skull that simply got to a point that started to press on her brain significantly, causing considerable neurological compromise," said Dr. Steven R. Flanagan, director of the Rusk Institute of Rehabilitation Medicine at New York University's Langone Medical Center in New York City. He was not involved in Richardson's care.

Flanagan said a diagnosis of hemorrhage would account for the headache that surfaced after the accident.

And, Fried said, "slow bleeding [could] take a few hours to make itself known."

"The brain is contained within the skull and the skull is a rigid box. There is no movement [possible]," Fried explained. "Any pressure that builds up will put pressure on the brain, which is very unforgiving and sensitive to pressure."

"It's not terribly common but someone can be perfectly lucid [after hitting their head], then go rapidly downhill," Flanagan said. "It's not a major surprise. It's clearly reported in the literature."

Dr. Eugene Flamm, chairman of neurosurgery at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, agreed. He stressed that the low-velocity, low-impact type of accident that Richardson seems to have experienced would typically not result in a grave outcome.

Such outcomes are "pretty rare," Flamm said. However, he added that it was certainly a possibility that physicians hold in their mind when seeing patients.

"It's quite unusual, but we see a lot of people in the emergen
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