This is really so sad.
The day we heard this, the consensus was that this was an epidural bleed caused by blunt trauma.
With the info now available, it seems likely that the epidural bleed was caused by blunt trauma to a particularly vulnerable area of her head just above her ear where the medial meningial artery is "very closely affixed to the skull and the dura".
Characteristic of this type of injury is the initial blow, followed by a lucid period such as Natasha had. The ensuing headache and mental status change one hour later is a huge red flag and is an acute neurologic emergency. The bleeding is creating immense and increasing pressure in what was once, only potential space prior to the injury.
Unfortunately for her and her family, the first team of paramedics were waved off after the initial injury. A paramedic may well have picked up on the more subtle signs and symptoms at this time and would have be trained in the potential problems based on the mechanism of injury. We'll never know...
Truth be told, most of us would have done the same as Natasha. She probably said something like, I bumped my head, it's no big deal.
With the info out there, it's difficult to piece together the timeline and events. The second team of paramedics were called to her hotel room and found her with a severe headache, still conscious, but "not in too good a shape". She was transported to a local hospital and then to Hopital de Sacre Coeur in Montreal and then to Lenox Hill Hospital in New York City.
Not to beat a dead horse, but this is exactly the type of injury that could have been prevented with a helmet.
My thoughts and prayers go out to her family