Thursday, March 19, 2009
Natasha Richardson, Epidural Hemorrhage and Canadian Health Care
This CT scan (LEFT) shows 4 TYPES of intracerebral hemorrhage:
1. EPIDURAL short white arrow;
2. SUBDURAL short black arrow
3. SUBARACHNOID long black arrow
4.INTRAPARECNCHYMAL ( = in the brain matter itself)
long white arrow
Yesterday it was my conclusion that Natasha Richardson suffered from a subarachnoid hemorrhage (from a ruptured aneurysm)rather than an epidural or subdural hemorrhage because, as I said:
"Both epidural and subdural hematomas should have / would have been rapidly diagnosed and she would have had an emergency procedure to release the pressure."
In other words, it was my assumption that if she had an epidural or subdural hematoma it would have been rapidly treated when she was taken to a local hospital --Centre Hospitalier Laurentien--after falling ill with a recent history of head trauma.
So if Natasha Richardson had an epidural hemorrhage, the question becomes: did she get a STAT CT scan and was there a neurosurgeon at the hospital, or nearby on call who would be able to do the emergency procedure needed to save Natasha Richardson's life?
Canadian Health Care
It's important to ask this question, because this is precisely the situation where the Canadian-type health care system -- much touted by reform advocates -- tends to fail Canadians.
In the United States, we pay a lot for health care, but that care is widely dispersed, into communities, with high-level diagnostic and therapeutic options available in fairly wide-flung areas.
In Canada, there are only 10.3 CT scanners per million people whereas the U.S. has 29.5 per million...so it is reasonable to ask if Centre Hospitalier Laurentien has a CT scanner, and did Richardson get a CT of the brain STAT?
In the United States if someone falls and hits her head and then an hour later is rushed to the emergency room you can bet she will get a STAT CT scan and immediate neurosurgical attention.
Can you bet that Natasha Richardson got that care? I hope so. I do have some doubts because shortly after being admitted to Centre Hospitalier Laurentien, she was shipped out to a larger hospital in Montreal; and, of course, later that day she was pronounced brain dead.
I hope Natasha Richardson got the appropriate health care and that this was all a tragic and improbable occurrence. But if not, it would be an important thing to know.