Head Injured can Appear Okay at First
The surprising death of actress Natasha Richardson caused by a seemingly simple injury has ignited talk and education on the reality of traumatic brain injury. CNN medical producer Danielle Dellorto, brought to light the unbiased nature of the injury. In an interview with Dr. Carmelo Graffagnino, director of Duke University Medical Center’s Neurosciences Critical Care Unit, he told CNN how common it is for someone who has had a fall or been in a car accident can appear lucid just after the impact but then to suddenly and rapidly deteriorate.
The rapid deterioration was likely due to a brain bleed called an epidural hemorrhage according to Graffagnino, “A patient can appear so deceivingly normal at first, but they actually have a brain bleed and as the pressure builds up, they’ll experience classic symptoms of a traumatic brain injury.”In an epidural hemorrhage blood gets trapped between the skull and the hard layer of skin between the bone and brain, known as the dura mater. As the blood flows from the ruptured artery, the fluid builds and punctures the dura. Patients are often unaware of the fracture to their skull, in such cases the fracture generally occurs just above the ear in the temporal bone.
“There is an artery that runs above the skull and can get torn and begin to bleed above the lining of the brain.” Graffagnino says. “At that point all the pressure is pushed on the brain, causing it to swell but there is often no room for it to move inside the skull cavity. And as the pressure continues, it reduces blood flow to the brain and a patient would begin to feel the symptoms.”He continues to say that the initial impact doesn’t have to be hard and the delay in symptoms can range between five minutes and three hours post injury. It is imperative that an individual who has suffered an impact to the head seek medical attention immediately. Symptoms of a brain injury include nausea, severe headache, glossy eyes and sudden sleepiness. Immediate treatment is essential after a brain injury because the initial damage caused by swelling often is irreversible.
