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.
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“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 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 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 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.
She met Neeson when they made their Broadway debuts in 1993, co-starring in “Anna Christie,” Eugene O’Neill’s drama about a former prostitute and the sailor who falls in love with her.
Her most notable film roles came earlier in her career. Richardson played the title character in Paul Schrader’s “Patty Hearst,” a 1988 biopic about the kidnapped heiress for which the actress became so immersed that even between scenes she wore a blindfold, the better to identify with her real-life counterpart.
Richardson was directed again by Schrader in a 1990 adaptation of Ian McEwan’s “The Comfort of Strangers” and, also in 1990, starred in the screen version of Margaret Atwood’s “The Handmaid’s Tale.”
She later co-starred with Neeson in “Nell” and with Mia Farrow in “Widows’ Peak.”
Her final feature film, “Wild Child,” has been released internationally but has not been released in the U.S., and Universal Pictures said one had not been scheduled.
Richardson was born in London in 1963, the performing gene inherited not just from her parents (Redgrave and director Tony Richardson), but from her maternal grandparents (Michael Redgrave and Rachel Kempson), an aunt (Lynn Redgrave) and an uncle (Corin Redgrave). Her younger sister, Joely Richardson, also joined the family business.
She also is survived by two sons, Micheal, 13, and Daniel, 12.
Funeral arrangements will be handled by the Greenwich Village Funeral Home, Borakove said.
Friends and family members remembered Natasha as an unusually poised child, perhaps forced to grow up early when her father left her mother in the late ’60s for Jeanne Moreau. (Tony Richardson died in 1991).
Interviewed by The Associated Press in 2001, Natasha Richardson said she related well to her family if only because, “We’ve all been through it in one way or another and so we’ve had to be strong. Also we embrace life. We are not cynical about life.”
Her screen debut came at 4, when she appeared as a flower girl in “The Charge of the Light Brigade,” directed by her father, whose movies included “Tom Jones” and “The Entertainer.” The show business wand had already tapped her the year before, when she saw her mother in the 1967 film version of the Broadway show “Camelot.”
“She was so beautiful. I still look at that movie and I can’t believe it. It still makes me cry, the beauty of it,” Richardson said.
She studied at London’s Central School of Speech and Drama and was an experienced stage actress by her early 20s, appearing in “On the Razzle,” “Charley’s Aunt” and “The Seagull,” for which the London Drama Critics awarded her most promising newcomer.
Video: Remembering Natasha Richardson She and her mother acted together, most recently on Broadway to play the roles of mother and daughter in a one-night benefit concert version of “A Little Night Music,” the Stephen Sondheim-Hugh Wheeler musical.
Before meeting up with Neeson, Richardson was married to producer Robert Fox, whose credits include the 1985 staging of “The Seagull” in which his future wife appeared.
She sometimes remarked on the differences between her and her second husband — she from a theatrical dynasty and he from a working-class background in Northern Ireland.
“He’s more laid back, happy to see what happens, whereas I’m a doer and I plan ahead,” Richardson told The Independent on Sunday newspaper in 2003. “The differences sometimes get in the way but they can be the very things that feed a marriage, too.”
She once said that Neeson’s serious injury in a 2000 motorcycle accident — he suffered a crushed pelvis after colliding with a deer in upstate New York — had made her really appreciate life.
“I wake up every morning feeling lucky — which is driven by fear, no doubt, since I know it could all go away,” she told The Daily Telegraph newspaper in 2003.
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