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Natasha Richardson's Needless Death

Natasha Richardson was a British stage and screen actress who died at the young age of 45 from an epidural brain hemorrhage caused by a skiing accident. From this tragedy you can learn how to recognize the signs of severe head injury even when the person insists that they do not need any treatment.

Natasha was born and brought up in London in a famous British stage family. She was the daughter of director and producer Tony Richardson and actress Vanessa Redgrave, granddaughter of actors Sir Michael Redgrave and Rachel Kempson, niece of actress Lynn Redgrave and actor Corin Redgrave, and cousin of actress Jemma Redgrave. She starred in many films, stage productions and musicals and won:
* a Tony Award for Best Performance by a Leading Actress in a Musical,
* a Drama Desk Award for Outstanding Actress in a Musical, and
* an Outer Critics Circle Award for her on-stage performance as Sally Bowles in Cabaret.

Emotional Turmoil
Her parents divorced when she was four and her sister was one. She remembered that she planned to buy red roses, put her father's name on the card and send them to her mother so their parents would get back together and they could have a family again. Her parents never did reconcile, and she spent school holidays between her mother's London home and her father's huge estate in Provence. Her mother was too busy being an actress and a leftist political activist to be much of a mother. This forced Natasha to function on her own or to look to her father for guidance, but her father had lots of his own issues. When she was 11 years old she learned that he was bisexual.

Natasha appeared in her first movie when she was five and spent her entire life in the theater and film. She was overweight as a child and adolescent and did not lose the excess weight until she was in her twenties. She spent the rest of her life repeatedly losing and gaining weight, smoking, and drinking diet drinks. At age 21 she appeared in her first major movie, "Every Picture Tells a Story". When she was 28, her father died of AIDS. She helped raise millions of dollars for The American Foundation for AIDS Research.

She was intelligent, tall and beautiful with large green eyes and a deep, sexy voice. In 1985, she starred in "The Seagull" and fell in love with the producer, Robert Fox, who was 11 years her senior. She married him in 1990, the same year that she starred in Eugene O'Neill's "Anna Christie". The play was such a success that when a Broadway production was planned, she suggested that an Irish actor named Liam Neeson be her co-star. In 1992 she divorced Fox and followed Neeson to Poland while he was filming Schindler's List. In 1994 they married and subsequently had two children.

An Unnecessary Death
In March 2009, she fell and banged her head while taking a beginner's ski lesson at the Mont Tremblant Resort in Quebec, Canada. Paramedics were called twice, but each time, she told them that she did not need medical help because she had only a headache and otherwise felt perfectly normal. This is called a "lucid interval" that should have been taken as a warning sign of the epidermal brain hemorrhage
that killed her.

The first 911 call came at 12:43 p.m. Monday, March 16. Medics arrived at the hill 17 minutes later. She refused medical help so the paramedics left while she was taken still conscious on a sled. She returned to her hotel room, but her headache became increasingly severe. At 3:00PM, a second 911 call was made and an ambulance arrived nine minutes later. She was conscious and spoke to the paramedics, but because she was irrational, they drove her to a hospital 40-minutes away in Sainte-Agathe-des-Monts, where she became unconscious. Doctors there recognized that she was bleeding into her brain and transferred her in an ambulance to a hospital 80 miles away in Montreal. The next day, she was flown to Lenox Hill Hospital in New York City. She died there on March 18 from an epidural hematoma.

Why She Died
The brain is covered by a thick coating called the dura mater located underneath the tough, bony skull. An epidural hematoma means that bleeding occurs outside the brain and its covering. That means that as the blood collects, it cannot expand outward against the tough immovable bony skull, so it has to press inward and crushes the much-softer brain. Since bleeding outside the brain is usually from a broken artery at high pressure, epidural bleeding often kills the patient. Epidural bleeds from arteries usually grow to their largest size in six to eight hours. Subdural bleeding, beneath the dura matter, is usually from veins, where pressure is lower, bleeding is slower and the patient is far more likely to be saved.

Early on, the patient usually has no brain damage so that a person is able to talk and may appear perfectly rational. This is called the "lucid interval" and explains why the paramedics were turned away the first time. However as the bleeding continues, the pressure on the brain covering increases to cause a horrendous headache. The collection of blood presses on the third cranial nerve to cause the pupil, the center spot in the eye, to become fixed and dilated on the injured side and the eye turns down and out. Other findings include weakness of arms and legs on the opposite side. Then the brain can be pushed down, compressing the breathing center in the brain, causing the patient to stop breathing and die.

Since the bleeding is continuous, the increase in pressure is also continuous and the pressure must be lowered before the patient stops breathing. The surgeon drills a hole in the skull and draws the blood out through the hole.

Helmets for All High-Impact Sports
Natasha did not wear a helmet while she was taking skiing lessons and hit her head. Any bang on the head can cause bleeding that can kill. Helmets help to absorb some of the shock, so they can prevent bleeding into the brain. We are bicycle riders and whenever we see a rider who is not wearing a helmet, we say: "He (or she) has nothing to protect."

Other Famous Skiing Deaths
Michael LeMoyne Kennedy, the sixth son of Robert Kennedy, died of an epidural hematoma at age 39 when he hit a tree on New Year's Eve on December 31, 1997. He was playing football on skis with several other members of the Kennedy family in Aspen, Colo. He was not wearing a helmet.

Sonny Bono died instantly from an epidermal hematoma when he hit a tree while skiing in Nevada on January 5, 1998, five days after Michael Kennedy died. He also was not wearing a helmet. He was half of the singing duo "Sonny and Cher" and served as U.S. congressman from the State of California.

Doak Walker, the 1948 Heisman Trophy winner and one of college football's greatest athletes, died in a skiing accident at age 71. An expert skier, he hit a patch of ice, traveled 20 to 30 feet in the air and broke his neck. He was paralyzed from the neck down and died of complications several months later. He was not wearing a helmet, but helmets have not been shown to prevent neck injuries.

Natasha Jane Richardson
11 May 1963 – 18 March 2009

May 25th, 2014
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About the Author: Gabe Mirkin, MD

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