Talk and Die

Ever hear the story of the little kid who tripped over his own feet, took a tumble, got up and ran off to play…and then died later that night?  Remember Natasha Richardson, Liam Neeson’s unlucky wife who took a seemingly insignificant spill while skiing, seemed okay, and refused treatment…and ended up dying later on?

See?  This is why I’m so cautious and wary of head injuries, even minor bumps on the head…especially when it involves my child.  Maybe sometimes I seem like I’m paranoid, or a hypochondriac; probably I am.  They (whoever “they” are) also say a little knowledge can be a dangerous thing.  So maybe it’s a combination of too much knowledge and too much anxiety (and too little Valium.)

Once, I was in a car accident, rear-ended by some bitch in an SUV.  I don’t just say that cuz she hit me; she actually was a bitch.  I wasn’t really hurt, but I got an almost immediate migraine.  So I had rode in the ambo, strapped to a backboard, to the ER.  The doctors didn’t even seem to think a CAT scan was necessary, but I made them do one. (It was kind of funny; I mentioned something about meningeal tears or something and the doctor gave me this stupid look and that was the end of the discussion.)  It ended up being not much more than really sever whiplash which set off a migraine…but it could have been serious.

It’s called “talk and die syndrome,” and it’s a sneaky bastard.  

They may not show signs of concussion or cranial bleeding, and they may be talking and have no difficulty walking or have other symptoms of neural damage. However, as the condition progresses, the person gets suddenly much worse, and damage at this point may be too significant to cure. In these cases, people go from talking and seeming fine, to comas or unconsciousness, from which they may not recover.  (source)

There are actually a few different types of injuries that can result in talk and die; the syndrome itself is more of a result than a cause of death from head injury, and is also known by the term lucid interval.  

One of the main causes is arterial dissection, resulting in an epidural hematoma, which in turn puts pressure on the brain as it grows in size.  Sometimes minor arterial tears can result in blood clots that could eventually cause a stroke.  People who are on aspirin or blood thinners may be at a higher risk for more serious injuries.

These types of head injuries may be comparable to or resulting from the types of contrecoup injuries sustained by people in automobile accidents who are traveling at great speeds and come to an abrupt stop (usually against an immovable object.)

Most fatalities are the result of relatively high speed impact (probably greater than 27 mph) with a fixed object (like a tree). (source.)

Basically, your brain smacks around inside your skull.

Fatalities from head injuries of these types can sometimes be prevented if the damage is caught early on.  Sometimes, fatalities can occur even with early detection.  Your best bet if you have any doubts or fears after a fall, collision, or similar injury is to be evaluated.  In the event that you decide not to be evaluated, recognizing the symptoms of a possible brain injury is critical.

Nausea, severe headache, glossy eyes, sudden sleepiness, are all common symptoms. Getting to a hospital within the first few hours is critical to prevent permanent brain damage, experts say… Immediate treatment is essential after a brain injury because the initial damage caused by swelling often is irreversible. (source)

So there’s your daily dose of info from me, plus some fuel for your hypochondria.  But seriously, it pays to play it safe with your brain.  Literally.  The human body is complex, strong and yet fragile.  Some people survived terrible accidents– shootings, stabbings, fire.  They have suffered terrible injuries to their bodies, and have made recoveries that were nothing short of miraculous, defying the odds simply by living.  Jacqueline Saburido was hit by a drunk driver and trapped in her burning car for almost a minute and suffered burns to 60% of her body.   Other people have died from seemingly insignificant mishaps or injuries.  Rita Johnson died of brain injury after being hit on the head with a falling hair dryer.  Howard Hawks suffered brain injury after tripping over his dog.

Bottom line is when in doubt, get checked out…and don’t let other people make you feel foolish for “being a worrywart” or a hypochondria.  You only get one life.