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NEW YORK - Tony-winning actress Natasha Richardson died of a brain injury after falling on a ski slope, an autopsy found Thursday. The cause of death was epidural hematoma (bleeding between the skull and the brain's covering), said Ellen Borakove, a spokeswoman for the New York City medical examiner's office. Richardson was not wearing a helmet and the death was ruled an accident.

An epidural hematoma is often caused by a skull fracture. The bleeding causes a blood clot that puts pressure on the brain. That pressure can force the brain downward to press on the brain stem that controls breathing and other vital functions, causing coma or death. Frequently, surgeons cut off part of the skull to give the brain room to swell.


Richardson said she felt fine after her spill but became ill later and complained of a headache. Doctors say sometimes patients with brain injuries have what's called a "lucid interval" where they act fine for an hour or more as the brain slowly, silently swells or bleeds.

Symptoms_ headache; loss of consciousness; vomiting; problems seeing, speaking or moving; confusion; drainage of a clear fluid from the nose or mouth - appear after enough pressure builds in the skull.

Emergency surgery is often need to drain the blood or remove the clot.

"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."