Here is a true story for all to read and to share so others may benefit. A while back, there was a 12 year old boy who fell from the merri-go round on the playground at his school. He was dazed for a moment but acting fairly normal. He was taken to the school nurse after which he was brought home by his mother. Once home, the boy complained of a headache but nothing more. After dinner time, his parents noted him to be sleepy and disengaged. Both thought he was just tired and considered putting him to bed early in hopes he would feel better in the morning. But a mother’s intuition kicked in and she knew something was wrong.
She took him to the emergency department to be evaluated. At the emergency department, the child was very sleepy but would arouse, talk, and then quickly fall back asleep. He simply seemed to be very tired. A CAT scan was performed showing a large blood clot over his brain. The blood clot was putting pressure on the brain. I was the Neurosurgeon called to evaluate the boy in the emergency department that evening. I reviewed the CAT scan, examined the child and recommended emergency brain surgery to remove the blood clot. The parents were beside themselves as they had considered putting their child to bed that night to see if he would be better by the morning. If they would have done so, the boy most likely would have not woken up the next morning and could have very well died in his sleep. The child was in surgery within the hour. At surgery, I found an enormous blood clot pressing on the brain which was easily removed. I found a hairline skull fracture which had ruptured an artery and resulted in the bleeding. Post-operatively, the child did well. He was back to his normal self after surgery and was discharged to home with his parents several days later.
His post-operative CAT scan showed the blood clot to be gone. I have seen him back in the office several times since his discharge. He is a normal 12 year boy back to life as usual. With his parents permission, I have included the pre-op and post-op CAT scan images to show you what an epidural hematoma pressing on the brain looks like before surgery and how the brain looks after the blood clot is gone. This real life story nicely illustrates the power of a mother’s intuition, especially regarding her own child. Always trust your gut instinct when you’re not sure of something. More often than not, you’ll be right. This young boy had what’s called an “epidural hematoma” which is the same type of blood clot that actress Natasha Richardson died from in 2009. She was married to Liam Neeson at the time. She died after falling on a bunny hill while taking a ski lesson at a resort near Montreal. She initially felt fine, was awake, talking and acting normally. This is called the “lucent interval”.
She declined medical attention at the resort because she felt fine and subsequently returned to her hotel room. Within hours, she fell sick complaining of a headache and was rushed to the hospital where she was declared brain dead many hours thereafter. She never made it to surgery. She was not wearing a helmet at the time of her fall. An autopsy revealed that she died from an epidural hematoma. Natasha Richardson’s death may have been preventable if she or anyone else around her would have had a higher degree of suspicion for injury or if she had accepted treatment when she had the chance. There is power in knowledge. Unfortunately, no one strongly suspected an epidural hematoma or brain injury when she was initially acting fine. Obviously, hind sight is 20-20 and I don’t have all the details surrounding her death to make any conclusive statements but you get the general idea. Always have a higher degree of suspicion for injury when someone hits their head, especially if they are complaining of a headache or acting tired afterwards. Epidural hematomas cause increasing pressure on the brain as the blood clot enlarges.
The most common symptoms include headache, sleepiness, nausea/vomiting or altered mental status. If you note someone having these symptoms after hitting their head, you should have them promptly evaluated at your local emergency department. And remember, always follow your natural instincts on these matters because usually they are right, especially when it pertains to a parent’s intuition. On a final note, always encourage, and if you can, make your children wear a helmet when they are riding their bike, skate boarding, roller blading or skiing. That one simple measure, which they will certainly fight you on, can save their life. If you have found this post interesting or helpful, PLEASE SHARE for others to read. And stay tuned for more Real Life Neurosurgery stories to come a www.BrianMatters.com.