Some of the nitty gritty on head injuries, even when the skull stays intact:

http://health.lifestyle.yahoo.ca/cha...ation_id=35177

Dr. Cameron Guest, an intensive care physician at Sunnybrook Health Sciences Centre in Toronto, said the apparent progression of Richardson's symptoms are typical of an extradural, or epidural, hematoma.

"This is the kind of injury that can do that sort of thing, where bleeding from an injury to an artery inside the skull leads to compression of the brain," he said. "If blood accumulates inside the skull, because it's a hard space, it can't expand and the brain gets compressed."
Tator said that when blood collects or clots inside the skull, pressure builds up and pushes the brain downward. Unless this aggregation of blood is removed and the pressure released through surgery, the brain stem can become compressed.

"And that's when the serious, generally irreversible damage occurs," Tator said. "So if there has been damage to the brain stem, those people generally don't wake up. They either die or remain in a vegetative state."

According to reports, Richardson appears to have had a period of "lucidity" between her fall and the onset of symptoms. If she then lost consciousness, that interval would have raised a red flag for doctors about the potential course of her condition.

"If they (patients) become comatose after this lucid interval, then you're on a sliding scale of who's going to wake up and who isn't going to wake up from this type of injury," Tator said.

In other words, time is of the essence, he said, noting that the relative closeness of Mont Tremblant to Montreal hospitals with experienced neurosurgeons could have been one factor in Richardson's favour.
That poor family....