You have probably heard or read about the heartbreaking skiing accident suffered yesterday in Montreal by Tony Award-winning actress Natasha Richardson, who is 45. She had fallen during a beginner's ski lesson. At first the fall appeared not to be serious, because she hadn't hit anything and because she got up, was talking and walking, and said she was okay. Beginner's slopes are, naturally, full of tumbles, and it sounds as though nothing seemed out of the ordinary to those around her at the time.
Her instructor and a member of the ski patrol stayed with her, however, and when she began having severe headaches an hour later, she was taken to the hospital. Since then, her condition has worsened. She was flown to Lenox Hill Hospital in New York, where her family has gathered around her. Some reports suggest that she on life support and not expected to recover. She is married to actor Liam Neeson, and they have two sons.
Here's the New York Times story about Richardson:
http://www.nytimes.com/2009/03/19/us/19richardson.html?ref=arts
As anyone who has suffered with or who has watched a loved one suffer with a head injury knows, they are unpredictable, sometimes perplexing, and often frightening. I was at a softball game once where a close friend fell and hit the back of her head while sliding into first base. She got up, talked, joked, ran around the rest of the bases when her time came, and came back to the dugout. She said it hurt, and asked for some Advil. She didn't want to be taken to the hospital. But when, about 20 minutes later, she started repeating herself, didn't remember taking the Advil, and had to be told what was going on, we took her there. She had a serious concussion and she was in various states of recovery from it for about two years. But none of us would have guessed that right away, due to the way she got up after hitting her head and continued playing, talking and laughing. It was only a bit later that it was clear she wasn't feeling right.
Some believe that Natasha Richardson, as well as all skiers, should wear a helmet on the slopes. Bicycle helmet laws are common now, though many people choose to ignore them. But head injuries happen every day -- in car accidents, on playgrounds, while roller skating, even in a simple slip and fall. Especially if you are a parent, it helps to know what to watch for when you see someone take a hard bump to the head.
A person with a head injury may be outwardly bruised, injured or bleeding, but not necessarily. The injury occurs when the soft surfaces of the brain hit against the hard surface of the inside of the skull, which is not apparent from the outside.
Here is EmpowHer's page on head injuries and concussions:
https://www.empowher.com/media/reference/concussion
And here is some information from the National Institute of Medicine/ National Institutes for Health website:
"The symptoms of a head injury can occur immediately or develop slowly over several hours or days. Even if the skull is not fractured, the brain can bang against the inside of the skull and be bruised. The head may look fine, but complications could result from bleeding or swelling inside the skull.
"When encountering a person who just had a head injury, try to find out what happened. If he or she cannot tell you, look for clues and ask witnesses. In any serious head trauma, always assume the spinal cord is also injured.
"The following symptoms suggest a more serious head injury -- other than a concussion or contusion -- and require emergency medical treatment:
--Changes in, or unequal size of pupils
--Convulsions
--Distorted features of the face
--Fluid draining from nose, mouth, or ears (may be clear or bloody)
--Fracture in the skull or face, bruising of the face, swelling at the site of the injury, or scalp wound
--Impaired hearing, smell, taste, or vision
--Inability to move one or more limbs
--Irritability (especially in children), personality changes, or unusual behavior
--Loss of consciousness, confusion, or drowsiness
--Low breathing rate or drop in blood pressure
--Restlessness, clumsiness, or lack of coordination
--Severe headache
--Slurred speech or blurred vision
--Stiff neck or vomiting
--Symptoms improve, and then suddenly get worse (change in consciousness)
"Get medical help immediately if the person:
--Becomes unusually drowsy
--Behaves abnormally
--Develops a severe headache or stiff neck
--Loses consciousness, even briefly
--Vomits more than once."
And call 911 if you believe it's necessary. It's safer to leave transport in the hands of professionals when a person is injured and/or unconscious.
Here is more information from that site:
http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm