Quick treatment could have saved Richardson

updated 10:58 p.m. ET March 19, 2009

NEW YORK - Actress Natasha Richardson died from bleeding in her skull caused by the fall she took on a ski slope, an autopsy found Thursday. The medical examiner ruled her death an accident, and doctors said she might have survived had she received immediate treatment. However, nearly four hours elapsed between her lethal fall and her admission to a hospital.

Richardson suffered from an epidural hematoma, which causes bleeding between the skull and the brain’s covering, said Ellen Borakove, a spokeswoman for the New York City medical examiner’s office.

Such bleeding is often caused by a skull fracture, and it can quickly produce a blood clot that puts pressure on the brain. That pressure can force the brain downward, pressing on the brain stem that controls breathing and other vital functions.

Patients with such an injury often feel fine immediately after being hurt because symptoms from the bleeding may take time to emerge.

“This is a very treatable condition if you’re aware of what the problem is and the patient is quickly transferred to a hospital,” said Dr. Keith Siller of New York University Langone Medical Center. “But there is very little time to correct this.”

To prevent coma or death, surgeons frequently cut off part of the skull to give the brain room to swell.

“Once you have more swelling, it causes more trauma which causes more swelling,” said Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center in the nation’s capital. “It’s a vicious cycle because everything’s inside a closed space.”

Richardson, 45, died Wednesday at Lenox Hill Hospital in Manhattan after falling at the Mont Tremblant resort in Quebec on Monday.

Details of her treatment have not been disclosed.

It remained unclear Thursday exactly how she was injured. Resort officials have said only that she fell on a beginner’s trail and later reported not feeling well.

A CT scan can detect bleeding, bruising or the beginning of swelling in the brain. The challenge is for patients to know whether to seek one.

“If there’s any question in your mind whatsoever, you get a head CT,” Aulisi advised. “It’s the best 20 seconds you ever spent in your life.”

Broadway dims lights in her honor
Richardson's husband Liam Neeson and mother Vanessa Redgrave were among family members who went to Broadway as theaters dimmed their lights in tribute to the Tony-winning actress Thursday night.

The theaters dimmed their lights for one minute at about 8 p.m., the traditional starting time for Broadway evening performances. Also present were Richardson’s sister, Joely, and actors Matthew Broderick, Sarah Jessica Parker and Ron Rifkin.

“The Broadway community is shocked and deeply saddened by the tragic loss of one of our finest young actresses, Natasha Richardson. Her theatrical lineage is legendary, but her own singular talent shined memorably on any stage she appeared,” said Charlotte St. Martin, executive director of The Broadway League, the trade organization for Broadway theaters and producers.

Sam Mendes, who directed the Broadway musical “Cabaret” for which Richardson won a Tony, said: “It defies belief that this gifted, brave, tenacious, wonderful woman is gone.”

Video   Shock, sorrow over Richardson March 19: The British actress died Wednesday in a New York City hospital after hitting her head in a skiing accident. NBC’s Mike Taibbi reports on the shocked reaction in New York’s theater community. Today show

Actress Judi Dench told the BBC that Richardson was “a really great actress” who had “an incredibly luminous quality, that you seldom see, and a great sense of humor.”

“She was a wonderful woman and actress and treated me like I was her own,” said Lindsay Lohan, who as a preteen starred with Richardson in a remake of “The Parent Trap” in 1998. “My heart goes out to her family. This is a tragic loss.”

Yves Coderre, director of operations at the emergency services company that sent paramedics to the Mont Tremblant resort, told The Globe and Mail newspaper that he reviewed the dispatch records and the first 911 call came at 12:43 p.m. Monday.

Coderre said medics arrived at the hill 17 minutes later. But the actress refused medical attention, he said, so ambulance staffers turned and left after spotting a sled taking the still-conscious actress away to the resort’s on-site clinic.

At 3 p.m., a second 911 call was made — this time from Richardson’s luxury hotel room — as her condition deteriorated. An ambulance arrived nine minutes later.

“She was conscious and they could talk to her,” Coderre said. “But she showed instability.”

Video   How a bump on the head can lead to death March 19: NBC’s chief medical editor Dr. Nancy Snyderman talks about how a minor bump on the head can turn tragic and why helmets are so important. Today show

The medics tended to her for a half-hour before transporting her to a hospital a 40-minute drive away.

On Thursday, the ski resort where Richardson had her fatal fall was subdued, as employees refused to speak about the accident.

Still, the sunny slopes were crowded — and the gentle hill Richardson fell on was teeming with beginners, many of them children.

Death sparks ski helmet debate
Dozens of skiers and snowboarders took breaks from the runs to discuss Richardson’s death — and many said they bought a helmet because of Richardson.

“I bought a helmet yesterday after I heard,” said Nathalie Beaulieu, 41. “My daughters always wear them, but now my husband and I will, too.”

Slideshow   Reflecting on Richardson A pictorial look at actress Natasha Richardson’s life and career as a member of an acting dynasty more photos

Not everyone said they would change their ways.

“I haven’t worn one up to now and I’m OK,” said Jacques Garnier, 45. “My kids wear them, for sure, though.”

A spokesman for the family, Los Angeles-based Alan Nierob, said he had no information about funeral arrangements. In lieu of flowers, the family asked that donations be made to the amfAR foundation for AIDS research, Nierob said. Richardson, whose father died of complications from the disease in 1991, was a longtime supporter of the charity and served on its board of trustees since 2006.

Like other family members, Richardson divided her time between stage and screen. On Broadway, she portrayed Sally Bowles in the 1998 revival of “Cabaret.” She also appeared in New York in a production of Patrick Marber’s “Closer” (1999) as well as the 2005 revival of Tennessee Williams’ “A Streetcar Named Desire,” in which she played Blanche DuBois opposite John C. Reilly’s Stanley Kowalski.

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