Actress suffers brain injury

Theater and film actress Natasha Richardson suffered a serious brain injury in a Canadian skiing accident and was flown to New York on Tuesday, according to wire service and newspaper reports.

The 45-year-old British performer -- who is married to Liam Neeson and is the daughter of Vanessa Redgrave and the late film director Tony Richardson -- fell on a beginner slope Monday afternoon at Mont Tremblant, a Swiss-style luxury winter resort about 80 miles northwest of Montreal.

The star of the 1998 film “The Parent Trap” and the Tony-winning lead in the 1998 Broadway revival of “Cabaret” apparently was not wearing a helmet at the time of the accident.

“She was accompanied by an experienced ski instructor who immediately called the ski patrol,” the resort said in a statement. “She did not show any visible sign of injury but the ski patrol followed strict procedures and brought her back to the bottom of the slope and insisted she should see a doctor.”

Mont Tremblant spokeswoman Catherine Lacasse told the Associated Press that Richardson was getting a private lesson and that the actress said she was “fine at first.”

“An hour later she said she didn’t feel well. She had a headache, so we sent her to the hospital,” Lacasse said. “There were no signs of impact and no blood, nothing.”

Richardson initially was transported from the resort to the local hospital Centre Hospitalier Laurentien, then was moved to Montreal’s Sacre-Coeur hospital. The Canadian Broadcasting Corp. said Richardson left Canada on Tuesday afternoon on a private plane, accompanied by medical staff.

It was not immediately clear if she was accompanied by Neeson, who had been in Toronto filming the movie “Chloe.” They are parents to two young boys.

Richardson appears to have what is often called “talk and die syndrome,” which is usually due to delayed bleeding from an artery in the brain, according to Dr. Christopher Giza, a neurologist at the UCLA Brain Injury Research Center. Because arterial blood is under high pressure, blood can accumulate rapidly in the brain, pushing the brain to one side and leaking down into the brainstem, where it can “cause a change in mental status, the onset of a coma or, in severe cases, kill the person,” he said.

Such injuries are not common, “but they do occur, even in patients that have been evaluated by a CT scan,” said Dr. Keith Black, a neurosurgeon at Cedars-Sinai Medical Center. “That’s why, when a person has a head injury, we like to observe them for 24 hours, to make sure no delayed bleeding occurs.”

When patients like Richardson develop problems, the first thing physicians do is put them on a respirator to increase oxygen flow to the brain and heart. The respiration rate is typically set high to remove carbon dioxide, which increases swelling. Physicians would also give them diuretics to remove fluids and steroids to minimize swelling.

But if there is bleeding or a clot has formed, “the only way to fix it is to perform emergency surgery to drain the blood and fix the clot,” Giza said. The other treatments “are only temporizing measures. . . . If the blood clot is growing, you are only treating the symptoms and not the cause.”

It is also possible that she suffered a torn artery in the neck, which would produce similar symptoms but would potentially be more lethal, Black said. The situation could also be more severe if she had any inherent problems before the accident, such as a tendency to not clot well or an arteriovenous malformation in the brain -- basically a tangle of blood clots -- that could tear apart in an accident and cause bleeding.

Richardson’s publicist did not immediately respond to phone and e-mail messages.

Having starred in several dozen movies (including “Maid in Manhattan,” “Nell” and “The Handmaid’s Tale”) and theater productions (“The Seagull,” “Closer” and “A Streetcar Named Desire,” among others), Richardson’s acting work has been sporadic in recent years.

But she had been considering a Broadway revival of “A Little Night Music” with her mother, following a well-received one-night staging they did of the Stephen Sondheim musical in January at Studio 54 in New York.

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