Do Helmets Help Prevent Traumatic Head Injury On the Slopes?

When she bumped her head on a bunny slope, no one immediately knew what happened to actress Natasha Richardson. 

She was up and talking and didn't complain. The question being asked today is whether a helmet could have prevented her death at the age of 45?

Details are such: she was taking a lesson on a beginner slope at Mont Tremblant ski resort near Montreal.  She had no helmet on when she fell at the end of the lesson. She struck her head but was able to carry on a conversation.  The instructor helped her down the slope (earlier reports said she was carried on a stretcher). The ski instructor reportedly told her to seek medical attention. She did not, but an hour later in her hotel room developed a severe headache and her condition quickly deteriorated and she was taken to a Montreal hospital.

The fall happened Monday, by Tuesday she was flown in a private jet to Lenox Hill Hospital in New York. She was reported to be brain dead and on a ventilator when she was detached from life support late Wednesday afternoon and died. 

The Helmet Debate 

Time Magazine reports on the helmet question.   The human body and head are designed to withstand collisions no more than about 15 mph.  In a collision the brain moves inside the skull causing swelling or bruising, called a concussion.  The worst outcome is a brain-bleed, which is life threatening.  Brain swelling may not be felt immediately, so staying with the person for awhile will tell you if they are stabilized.   

Concussions can occur in a series, the first one making a second concussion more likely.  Later concussions may become more life threatening, though no one knows whether Richardson had suffered any earlier head injuries. 

Helmets are no absolute assurance because they may not be effective for someone traveling fast, over 15 mph, falling on ice and hitting an object with their head.

For a skier going 10 mph or slower, they may not be necessary if the person lands in soft powder snow. Helmets are most helpful for someone traveling at moderate speed of any experience level, a helmet can help soften the blow to the head.

The National Ski Areas Association reports that helmet use is up from 25 percent in 2002-2003 to 43 percent of skiers and snowboarders surveyed last year.  There were 53 accident deaths at the slopes last year, nine from snowboarding and 44 from skiing accidents. Ski Slopes such as Vail, encourage youngsters enrolled in ski school to wear helmets.

Both Sonny Bono and Michael L. Kennedy died in seperate ski accidents without a helmet 11 years ago.

Huffington Post reports that, according to Dr. Dexter Sun, a neurologist at New York Presbyterian Hospital, this is a highly unusual case. 

Dr. Sun says Richardson may have had an underlying hematology, where a minor bleed can hemorrhage.   If she had been on a blood thinner like coumadine, that makes a brain-bleed more likely.  And it is possible that her accident was harder spill than reported, possibly causing a fracture at the base of the skull.

Dr. Sun says she would have had to have had a CT scan within minutes to determine if there was bleeding. Immediate surgery on her skull would have been performed to relieve pressure followed by medication, to give her any chance of pulling through. 

Each year over 1.5 million people suffer from a brain injury in the United States. Five million live with brain injuries.  #