This site, Inside Surgery, is new to me, but it has a good explanation of what happens in the ambulance, ICU, and operating room when a person has a brain injury of the type Natasha Richardson apparently sustained.
"Judging by the news reports, Ms. Richardson was awake and alert and talking immediately after the fall with a likely CGS of 15 (normal). She then deteriorated over the next several hours, complaining of not feeling well, and then a headache.
This clinical scenario where a person has a blow to head followed by a lucid or awake interval, followed by rapid and severe deterioration is characteristic of an epidural hematoma or clot. It is usually caused by a rupture in a brain artery, typically the middle meningeal artery. Epidural hematomas also occur in boxers and in patients that are struck in the head with a baseball or hockey puck."
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