March 19th, 2009
05:39 PM ET
By Val Willingham
The death of actress Natasha Richardson is tragic. A beautiful, vital 45-year-old goes for a ski lesson and falls. She gets up, declines medical care and goes back to her hotel. From there, the story takes a terrible turn. She becomes ill, and is transported to one hospital, then another and then finally to a third hospital near her home, where she dies two days later from brain injuries caused by an epidural hematoma. Her family, friends and fans are shocked. How can something as innocent as a ski fall kill you? Because, neurologists say, the brain, although complex, is a delicate organ. It's very vulnerable and it needs to be taken seriously. And even a bump on the head can take its toll. Unfortunately, I know this all too well.
Thirteen years ago, my husband, daughter and I were in a terrible car accident on the Florida Turnpike. On our way to Orlando, our vehicle was hit by a driver who had fallen asleep at the wheel. Although we all had our seat belts on, our car swerved and hit a bridge embankment. My husband's head went out the side window, hitting the windshield and the concrete. When EMS workers got to us, it looked as if a battle had taken place: burning cars, debris. And because my husband had a major slice to his head, blood was everywhere. I was not hurt, and my daughter had a minor cut from flying glass. They loaded us into ambulances and took us to two different hospitals, my husband headed for the local trauma unit. He stayed two days in the hospital. They stitched up his forehead and sent him home, mentioning that he may want to see his doctor once he got back to Washington, D.C. And although the whole thing was terribly traumatic, we left Florida three days later, with my husband behind the wheel of a rental car.
Because he felt fine and there seemed to be no urgency to his injuries, my husband went back to work and made an appointment with his doctor to have a CT scan two months later. When he got off the table, the radiologist asked him to sit down and immediately called a neurologist. As the doctor viewed the images, his face turned pale and he asked my husband how long had it been since he was in the accident. My hubby shrugged and said, "A couple of months." The physician then told him not to move - he was going to schedule surgery immediately. It seemed my husband had developed a subdural hematoma that covered his entire brain. According to MayoClinic.com it's usually formed from head trauma that causes the brain to be shaken severely. Many children who suffer from shaken baby syndrome have these type of injuries. And unlike epidural hematomas, which bleed in the brain fairly quickly, my husband's injury developed slowly, causing a massive bruise to form. One false move could have given him a stroke, or caused permanent brain damage.
Although my husband made it through brain surgery without incident, there is a lesson here. Never take a head injury for granted. When doctors looked at his scans in the ER in Florida, they obviously did not see the bruising that later formed over his brain. Because the brain is loaded with large and small blood vessels, head injuries can cause all sorts of serious problems. Studies have shown that athletes who suffer even minor concussions can develop neurological problems later in life. The brain is nothing to be messed with.
Ironically, March is Brain Injury Awareness Month. And although brain injuries are not as common as, say, broken bones, they do happen and many have serious consequences. They need to be treated immediately. In this story, my husband got treated, before suffering brain damage. He was fortunate. God bless her, but Ms. Richardson was not.
Have you ever faced head trauma? Know someone who has? What happened? We'd like to hear about it.
Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.
March 19th, 2009
11:39 AM ET
As a new feature of CNNhealth.com, our team of expert doctors will answer readers’ questions. Here’s a question for Dr. Gupta.
Asked by Sharon, Montgomery, Texas
"I just heard that this month is Deep Vein Thrombosis Awareness month, and that Heidi Collins has had DVT. My question is, does she also have factor V Leiden? I know she has celiac disease and just wonder if that was the cause of her blood clot or was it factor V? Did the news anchor who passed away in Iraq have factor V Leiden? Thank you for asking her this for me. I am curious because while I haven’t had DVT, I do have factor V Leiden."
Thank you Sharon for being such a loyal viewer of CNN and for this question. Deep vein thrombosis, or DVT develops in over 2 million Americans each year. Yet many people are not familiar with DVT, or the signs and symptoms. And getting treatment early can be the difference between life or death.
Simply put, DVT is a blood clot that develops in a vein in your leg. This clot restricts blood flow to the heart. In serious cases, the it can break apart, travel through the circulatory system and end up in the lungs. This often-fatal condition is known as a pulmonary embolism. DVT develops in seemingly healthy people of all ages, however, certain factors do increase your risk. Blood clots are most prevalent in smokers, during pregnancy, after undergoing an operation, and after sitting for long periods during air travel.
Genetic factors can also play a role. Factor V Leiden is a genetic mutation that increases a persons risk of developing a blood clot. Up to 40 percent of people who develop DVT are carriers of the gene.
People often don’t know they have factor V because doctors don’t regularly screen for it. Former NBC correspondent David Bloom, who died from a blood clot while covering the war in Iraq, was a carrier of the factor V Leiden mutation.
His wife, Melanie Bloom, revealed in a CNN interview, that it wasn’t until after her husband’s death that they discovered he had the mutation. However she believes it was a combination of risk factors that lead to his death–not just factor V. “Along with the restricted mobility and dehydration and the long-haul flights leading up to embedding with the troops, we found, after doing David’s autopsy, that he had a gene–factor V Leiden that did predispose him. But it just added to his other risk factors,” Melanie Bloom said.
My friend, and CNN Newsroom anchor, Heidi Collins discovered she had a serious blood clot after experiencing a cramp in her leg. We sent Heidi your question, here is her response:
“The doctors in the emergency room at the Air Force Academy found my clot back in 1997 after I experienced severe leg pain. Four months later after arterial bypass surgery I was out of the hospital and was cured. Literally. No more clot, and no more complications. Unfortunately, to this day, none of the team of 20 doctors at the Mayo Clinic could determine what caused my clot. I was tested for factor V and I did not have the gene. The only thing my blood continued to show was a positive ANA (anti-nuclear antibody). It usually indicates there is something going on with the immune system; typically an indication of an autoimmune disease. Sadly, even after that continuous finding, I was not tested for celiac disease. Lupus was one of many diagnoses but no mention of celiac disease, which I knew nothing of until about eight years later. As far as I know, there is no connection that can be proven between celiac and DVT. But I can say that I have now met four other people with celiac disease that have had clots. Personally, it sure would explain a lot about why I got so sick all those years ago. I will be watching very closely to see if a link can be made.”
Sharon, I was happy to read that, despite being a carrier of factor V, you have not developed DVT. By knowing you’re genetically predisposed to clots, you can make lifestyle changes to lower the risk of it occurring in the future.
Anyone who experiences unusual leg cramps, swelling, redness or skin warm to the touch should seek medical attention immediately. It could be an early sign of DVT.
To learn more on how to prevent DVT and about factor V Leiden, click here.
Heidi Collins is the spokesperson for the National Foundation for Celiac Awareness. Find out more by clicking here.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.