Thursday, March 26, 2009

(CNN) -- Connie and Donald McCracken were watching CNN one evening last week when they learned of the tragic death of actress Natasha Richardson from a head injury. Immediately, their minds turned to their 7-year-old daughter, Morgan, who was upstairs getting ready for bed.

Two days earlier, Morgan, her father, and brother had been playing baseball in the yard of their Mentor, Ohio, home when her father hit a line drive that landed just above Morgan's left temple. A lump formed, but the McCrackens iced it down and the swelling subsided within an hour.

"For the next two days, she was perfectly fine," Donald McCracken says. "She had no symptoms. She went to school both days and got an A on her spelling test as usual. There were no issues whatsoever."

But after hearing about Richardson's death, the McCrackens wondered if Morgan was really as OK as she seemed. After all, Richardson had been talking and lucid immediately after her fatal injury.

When they went upstairs to kiss Morgan good night, she complained of a headache. "Because of Natasha, we called the pediatrician immediately. And by the time I got off the phone with him, Morgan was sobbing, her head hurt so much," McCracken says.

The McCrackens took Morgan to the emergency room at LakeWest Hospital in neighboring Willoughby, where doctors ordered a CT scan and immediately put Morgan on a helicopter to Rainbow Babies and Children's Hospital in Cleveland, with her father by her side.

"I knew it was bad when she had to get there by helicopter in six minutes, instead of the 30 minutes it would have taken to get to Cleveland in an ambulance," McCracken said.

When the helicopter arrived at Rainbow, the McCrackens were greeted by Dr. Alan Cohen, the hospital's chief of pediatric neurosurgery. He whisked Morgan into the operating room, pausing for a moment to tell McCracken that his daughter had the same injury as Richardson: an epidural hematoma.

McCracken remembers standing in the emergency room, feeling like the life had just been sucked out of him. "My heart sank," he says. "It just sank."

Unlike Richardson's, Morgan's story has a happy ending. After surgery and five days in the hospital, she's at home and doing fine. "Dr. Cohen told us that if we hadn't brought her in Thursday night, she never would have woken up," McCracken says.

Now the McCrackens sometimes wonder if they waited too long to get Morgan to a doctor. After hearing about Richardson's death, many people are asking themselves the same question: Do all head injuries need attention, even ones that seem minor?

"Sometimes there's a gray zone, and there's no right answer," Cohen says.

In most cases, it's pretty clear when someone needs medical attention after a head injury, says Greg Ayotte, a spokesperson for the Brain Injury Association of America and a cognitive rehabilitation therapist. "They're confused, they're agitated, or they might be dizzy or unresponsive," he says.

But then there's what doctors call the "talk and die" scenario, where someone seems fine, only to die hours, or sometimes even days later.

"Talk and die" can happen with several different kinds of brain injuries. In the case of epidural hematomas, the injury Richardson and Morgan had, blood pools in the area between the lining of the brain and the skull. "Fluid is building up in a contained space, creating pressure. Something's got to give, and that something is the brain," Ayotte says. If you don't get to the hospital to have surgery to drain the fluid, "the deterioration can happen very quickly."

This is where I feel lucky. I had a head injury six years ago. I hit my head so hard that I created a skull fracture so the blood had somewhere to drain, but I had months of rehabilitation and still have some problems with my vision and vestibular system. The best way it was explained to me is that if the blood is not drained it pools in your head, which is your bodies CPU, and shuts it down, sometimes quickly, sometimes slowly. It took famed Dr. Atkins 18 months to die from a closed head injury. I'm glad that Megan is alright, and I disagree with Dr. Cohen. There is no grey area. Head injuries have to be looked at, and if nothing is wrong, all the better, but letting them go can spell death. As a parent, I couldn't live with that.

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