On Monday of this week, Noah came in from outside with tears in his eyes. He had bumped his head playing, and it hurt. I gave him a long hug and suggested he take it easy for a while, which he did. I took little notice of him as he really seemed okay. It was the same day actress Natasha Richardson fell on a beginner ski slope in Canada and hit her head. Noah was fine. Richardson died.
I don’t think there is a parent out there who did not react to this story with complete sadness (Richardson was a mother of two boys) and utter fear (this could happen to my accident-prone kid, or me). So I did what I usually do with all of my paranoid medical questions – I called Geoff (Occasional FoDDER writer and physician extraordinaire). My questions this time around were especially relevant as Geoff is a neurologist and professor at Penn. And despite the fact that he did his undergraduate at Princeton, I trust him immensely.
Geoff spoke to me under the condition that I promised to urge all parents that this advice should never take the place of visiting a physician, especially in the cases of head trauma. If you take nothing away from this blog ever, please err on the side of caution, when it comes to seeking treatment for a head injury.
Here are my top 5 questions about Richardson and what he had to say (I paraphrased):
Em: Reports seem to indicate that Natasha did not suffer a traumatic fall, as she was on a beginner ski slope. How hard does one have to fall to sustain this type of injury? Can it be a mild fall? Is there something special about the fall that caused this? (I know this is three questions but I counted it as one.)
Geoff: Chances are this was not a tiny bump on the head. For an adult to experience epidural bleeding (which is how Richardson died), there is almost always a fracture to the skull. Children can sustain this injury without a fracture to the skull. Most commonly, the individual hits the side of their head near the temple to cause the artery there to bleed. The reports have been vague as to what actually happened but it is easy to envision a fall where the side of her head hit the powder and there were no external signs of trauma (like abrasions or bruising) but internally there was significant damage.
Em: It was also reported that she seemed fine and quite lucid after the fall, even refusing medical attention. Were their warning signs that could have been missed? What should you look for as a danger sign(s)?
Geoff: If there was any loss of consciousness, moments of confusion, weakness on one side or memory problems, those are warning signs that the individual should be seen by a doctor. This also hold true for a child. If the person doesn’t seem like themselves, appears sleepy, disoriented or generally out of it (beyond the normal out of it they usually are), they should be seen immediately and certainly not left alone.
Side note: Interestingly, people think that you need to keep a concussion patient awake because sleep would hurt them but actually you constantly wake them just to make sure they can wake up themselves and are not in a coma.
One more important thing is that if a kid has hit their head, parents must be extremely vigilant that the child does not hit the head again immediately following the initial trauma. This may sound obvious but in competitive sports, you may think your kid is ok and send them back on the fieid – a decision that can prove deadly if there is a second trauma to the head.
Em: How long does a person have to get treatment for this injury once it occurs?
Geoff: The treatment for an epidural hematoma is drilling a hole in the skull and draining the blood that has accumulated there. The length of time a doctor has to successfully perform this procedure is based on the size of the tear but it typically needs to be done within an hour or so. Once the person loses consciousness from the trauma, the situation has become dire.
Em: Would a helmet have saved her?
Geoff: Probably yes.
Gulp.
Em: How common or rare is this type of accident?
Geoff: If accounts are correct, what happened to Richardson is pretty unusual. People get concussions all the time but it is not common for it to result in an epidural bleed. Reports indicate now that a first ambulance was sent immediately and then turned away. You don’t call an ambulance to a ski slope for a minor fall. But this tragedy really underscores the importance of caution with all head traumas and reiterates that you should never leave a person alone who has suffered any type of head injury.
As a parent, I am always second guessing myself as to whether I am over reacting to a situation. I don’t want to be the psycho-Mom who freaks out whenever her kid takes a tumble. But damn it if I am not going to look a lot closer the next time that tumble takes place. Without ever knowing it, Natasha Richardson, in her death, probably saved countless lives. But it still makes me very sad.
*****
On a lighter note, speaking of head trauma, I had a piece on Babble.com yesterday about the sibling smackdown that goes on in my house on a daily basis… and why I am glad it does. If you haven’t read it, check it out and let me know what you think in the Babble comments.
A good weekend to all MoB readers.
