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.
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.
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Richardson fell on one of the resort's easiest ski runs Monday afternoon. She turned away immediate offers of medical help, but complained of a headache an hour later.
"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.
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.
Descended from one of Britain's greatest acting dynasties, including her mother, Vanessa Redgrave, Richardson was known for her work in such plays as "Cabaret" (for which she won a Tony) and "Anna Christie" and in the films "Patty Hearst" and "The Handmaid's Tale."
Broadway theaters planned to dim their lights Thursday in Richardson's honor at 8 p.m., the traditional starting time for evening performances.
