Traumatic brain injuries (TBIs) are among the leading causes of death and permanent disability in the United States. Data published by the Center for Disease Control (CDC) reveals that as many as 1.7 million Americans suffer a traumatic Brian injury each year. Brain injuries are not only caused by direct physical blows to the head, but can also be caused by sudden movement of the brain inside the skull. Automobile accidents, slip and falls and sporting injuries often can lead to some form of TBI.

TBI’s vary in severity and the problems they can cause are diverse. Headaches, memory problems, and changes in mood and personality are common effects of a TBI. More severe brain injuries can cause devastating cognitive changes and physical and mental functional disabilities. According to the CDC, TBIs are a contributing factor in more than a third of all injury-related deaths in the United States. Each year 52,000 people die as a result of sustaining a TBI and more than 270,000 are hospitalized. Anyone who suspects that they may have suffered a TBI should consult their doctor.

Burg Simpson attorneys have more than 30 years experience helping individuals who have suffered life changing traumatic brain injuries and their families rebuild their lives. Shareholder Peter W. Burg is Chairman of the Board of Directors of Colorado-based Craig Hospital – one of the world’s leading hospitals specifically dedicated to spinal cord injury (SCI) and traumatic brain injury (TBI) rehabilitation and research. For more information on legal issues associated with Brian Injuries contact Burg Simpson today for a free evaluation of your case.

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The widow of a 36-year-old traumatic brain injury victim secured a landmark verdict of $11 million when he died after ingesting foreign objects while under the care of an assisted living facility. As a result of a car accident, Earl Scherrer suffered a severe TBI. He remained in a coma for 16 months. After emerging from his coma his wife worked with him day after day helping him to slowly start to speak. After many hours of devotion to his care and recovery she was forced to return to work and had to rely on assisted living and residential facilities to provide his 24-hour care. After placing him, a month later she received a call saying her husband had been vomiting. He died in her arms. Autopsy results showed a number of items including plastic bags, unopened catsup packets, candy wrappers and paper towels were found in his stomach and small intestines. During the subsequent negligent death trial it came to light that the facility entered many false notations in his chart claiming care was given on the days that Mrs. Scherrer had him at home. The verdict included $2 million for the decedent, $5 million for the wife and $4 million in punitive damages. It was the largest verdict ever awarded against an assisted living facility in the United States.

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Innovative therapies are being increasingly used in traumatic brain injury cases. More recently the new therapies have been opened to military troops suffering from TBI. Over the past four years electronic brain stimulation, oxygen-induction using hyperbaric oxygen chambers, drugs and other therapies have been used to treat 43 people, including five soldiers, out of minimally-conscious or vegetative states according to Dr. Philip A. DeFina from the not-for-profit International Brain Research Foundation Inc. in New Jersey.

“There are a number of different types of (brain) injuries that we've been dealing with -- all of which have been responding to the protocols,” DeFina an Army veteran said. The therapies are combining to electrically and chemically stimulate the brain. The innovative therapies, DeFina said, have been used in a singular manner to successfully treat patients with brain injuries. Using those therapies in combination “is even more powerful,” he said.

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Every 23 seconds a traumatic brain injury occurs in the United States.

The chances of sustaining a brain injury are five times more likely than multiple sclerosis, spinal cord injury, HIV/AIDS and breast cancer combined.

The federal government spends less than $3 per brain injury victim on research and services.

Each year 475,000 children in the U.S. sustain a traumatic brain injury
Traumatic brain injury is the leading cause of death and disability among youngsters.

Those who have suffered a TBI are at an increased risk of developing Alzheimer’s and Parkinson’s disease.

Current care and rehabilitation practices prematurely discharge victims to nursing homes, psychiatric institutions or correctional facilities.

Continue reading "Traumatic Brain Injury Statistics " »

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The surprising death of actress Natasha Richardson caused by a seemingly simple injury has ignited talk and education on the reality of traumatic brain injury. CNN medical producer Danielle Dellorto, brought to light the unbiased nature of the injury. In an interview with Dr. Carmelo Graffagnino, director of Duke University Medical Center’s Neurosciences Critical Care Unit, he told CNN how common it is for someone who has had a fall or been in a car accident can appear lucid just after the impact but then to suddenly and rapidly deteriorate.

The rapid deterioration was likely due to a brain bleed called an epidural hemorrhage according to Graffagnino, “A patient can appear so deceivingly normal at first, but they actually have a brain bleed and as the pressure builds up, they’ll experience classic symptoms of a traumatic brain injury.”

“There is an artery that runs above the skull and can get torn and begin to bleed above the lining of the brain.” Graffagnino says. “At that point all the pressure is pushed on the brain, causing it to swell but there is often no room for it to move inside the skull cavity. And as the pressure continues, it reduces blood flow to the brain and a patient would begin to feel the symptoms.”

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Actress Natasha Richardson was reportedly in serious condition with a head injury after falling during a ski lesson on a beginner’s trail. The ski patrol following strict procedures brought her to the bottom of the slope and insisted she see a doctor. She declined. At first, she was fine, but within an hour she began to have a headache and finally went to the hospital. Sources close to Natasha Richardson say she is now brain dead and being flown back to New York, where she will be taken off of life support. Richardson’s story is a devastating one. Her entire life was ahead of her and this one moment in time changed everything. Her story is the story of thousands of others who have suffered a “bump” on the head, but do not seek treatment. It is imperative once a head injury is incurred, seemingly minor or not, to seek immediate treatment.

Dr. Steven Flanagan, director of Rusk Institute of Rehabilitation Medicine at New York University’s Langone Medical Center said, “When someone has bleeding between the skull and the brain, it basically presses on the brain, and if it presses enough… it can cause substantial damage and even death.” Flanagan continued, “What this implies is that someone hits their head and they are seemingly OK initially, but then they get a rapid collection of blood, usually called epidural hemorrhage, and that means bleeding between the skull and the brain.” Symptoms of an epidural hemorrhage include: headache; loss of consciousness; weakness on one side of the body; and a change in mental status. If the condition is not treated immediately, the person will fall into a coma and “it’s downhill from there. So you need to get the injury treated immediately.”

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Currently there are two accepted techniques to determine whether a traumatic brain injury has been incurred or not. One is a functional magnetic resonance imaging (MRI) and the other is the CT scan. Both are expensive. A new technology will be introduced by two Japanese scientists at the University of Houston that promises to deliver more comprehensive and accurate diagnosis at a fraction of the cost. The technology combines high-density electroencephalography (EEG) and near-infrared spectroscopy (NIRS) to detect cerebral blood flow. Combining the EEG and NIRS will study both electrical and metabolic activities at the same time to improve patient benefits. The device fits on a patient’s head and the configuration of fiber optics and special electrodes sends light into the brain. The light scatters as it travels through the layers of the brain tissue and is then reflected out and measured by a set of sensors.

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Many traumatic brain injury victims have a 400 percent increase risk of developing Alzheimer’s disease later in life. Now a new class of Alzheimer’s disease drugs may prevent long-term damage associated with traumatic brain injuries. According to a study of mice by Georgetown University Medical Center researchers, gamma-secretase inhibitors were used to target amyloid plaque that accumulates in the brain of those with Alzheimer’s disease.

“No one knows why it occurs, but abnormal amounts of amyloid plaque have been found during an autopsy in about a third of brain injury victims, some of whom were children who would ordinarily never have had these deposits,” Mark Burns, a neuroscientist and assistant professor at Georgetown and the study's lead author, said in a university news release. “In this study, we show that the same pathways activated chronically in Alzheimer's disease are activated acutely in traumatic brain injury and that they appear to play a very important role in secondary injury.”

“This is an exciting finding that we hope can be readily tested in patients with traumatic brain injury,” Burns said.

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In an effort to help with the number of traumatic brain injury victims in North Dakota, that state’s senate voted unanimously to support a bill to assist those who have incurred a TBI. Senate Bill 2198 proposes provisioning of specialized state services, including expanded vocational rehabilitation as well as instituting a traumatic brain injury registry not unlike the state’s cancer registry currently in operation. The bill also seeks to prevent future brain injuries through education. The bill will now go to the House.

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With a five year grant from the National Institutes of Health the Virginia Commonwealth University Medical Center is studying a new therapy for traumatic brain injury rehabilitation. It is one of the only programs of its kind and is called the First Steps Acute Neurobehavioral and Cognitive Intervention (FANCI). The program concentrates on patients’ survival and treatment.

“A lack of information and limited resources contribute to the long-term challenges of living with brain injury,” said Janet Niemeier, Ph.D., associate professor in the School of Medicine’s Department of Physical Medicine and Rehabilitation. ”Many people’s needs are not fully addressed by existing systems of care. FANCI aims to meet these needs by serving as a resource for brain injury survivors, family members and other caregivers.”

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Nearly two dozen Pennsylvania residents are recipients of a device that helps with foot drop after suffering a traumatic brain injury. The non-invasive device is the NESS L300 and straps below the knee. The NESS L300 works by electrically stimulating the leg nerves and muscles to raise the foot when walking. The device was first offered this past summer in the Pittsburgh region. Officials with Bioness Inc., makers of the medical device, said they are talking with West Penn Hospital in an effort to provide the NESS L300 for rehabilitation patients there. According to Bioness, more than 2.5 million people in the United States suffer from foot drop, with 200,000 new cases every year. The $6,000 device is at first worn only for 15 to 20 minutes at a time. Early results indicate the device is extremely helpful. However, many patients who could benefit from it aren't getting it because their insurance providers won't cover the cost.

Physical therapist Amy Vtipil says she expects the NESS L300 to retrain the neurons to lift the foot so eventually TBI patients will no long need it. “One of the ways you retrain the brain is repetition, and if this device allows you to repeat the correct movement over and over again with every step, it's conceivable that it could train a part of the brain to take over a function that is lost or relearn something it had all along,” she said.

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A Massachusetts woman and her family are suing as a result of a car accident that left the 26-year-old woman severely traumatic brain injured. The auto negligence lawsuit was filed in U.S. District Court in Boston. The lawsuit claims that the driver "negligently and carelessly" caused the wreck. The woman is still recovering according to her lawyer. “She's not doing well,” said attorney Andrew Abraham said, “She has suffered a pretty significant injury and probably will never fully recover.” The lawsuit does not specifically mention how much the family is suing for.

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Promising results have appeared in the treatment of traumatic brain injury in a study supported in part by the National Institute of Neurological Disorders and Stroke and the Rehabilitation Medicine Scientist Training Program. The study used noninvasive electrical stimulation of the brain that produced an improvement in the ability to learn complex motor tasks. Healthy participants who received a mild electric current applied to the primary motor cortex became more skillful at a complex motor task than those who did not receive the stimulation. To find out whether the stimulation would improve performance over time, the researchers recruited 24 healthy volunteers and assigned half to active stimulation and half to imitated stimulation while performing the task of moving a cursor around a computer screen in a specific pattern using touch sensors. Over the course of five days both groups learned the task, but the stimulated group achieved a significantly higher level of skill. All participants made five return visits over three months to evaluate retention of the skill and the two groups had similar skill levels. “The persistence of a beneficial effect of anodal transcranial direct current stimulation at three months after the end of training may have promising implications for the design of motor learning protocols in healthy individuals and in patients undergoing neurorehabilitation,” the researchers concluded. The findings could hold promise for enhancing rehabilitation for people with traumatic brain injury, stroke and other conditions.

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Traumatic brain injury comes with a host of side effects that can be a challenge for many families. It is not unusual for inappropriate behavior, irritability, anxiety and depression to express itself. A number of sensate issues arise including a persistent ringing in the ears, difficulty recognizing objects, impaired hand-eye coordination, blind spots or double vision. One of the more unique expressions is the experience of a bitter taste or a consistent bad smell with no known environmental reason. New findings indicate that a traumatic brain injury appears to increase the risk of eventually developing Alzheimer’s disease and to a lesser degree Parkinson’s disease. When speaking of TBI many are aware of the cognitive and physical rehabilitation used for recovery, but even in light of this there are still long term consequences.

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The American Psychological Association (APA) has corroborated previous studies on traumatic brain injury recovery finding that cognitive rehabilitation for the brain works in much the same way as physical therapy for the body does. Researchers at the University of South Alabama and the University of North Carolina analyzed research published in 2000 and 2005 of several hundred studies using cognitive rehabilitation. Researchers concluded:

-Generally, it is better to start treating patients as early as possible, rather than waiting for a more complete neurological recovery.

-Even older patients (age 55 and up) may benefit from cognitive rehabilitation, particularly if the brain injury is due to stroke.

-Clinicians should focus their efforts on direct cognitive skills training in specific cognitive areas such as attention or visuospatial processing.

Their findings were published in the January issue of Neuropsychology entitled, “Effectiveness of Cognitive Rehabilitation Following Acquired Brain Injury: A Meta-Analytic Re-examination of Cicerone et al.'s (2000, 2005) Systematic Reviews.”

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A new memoir by author Debra Sanders and published by Outskirts Press, Inc. in Parker, Colorado called “A Matter of Panache” relates her experiences as she fought with school administrators and teachers after suffering a traumatic brain injury after a work-related car accident. The autobiography details how after butting heads with school administrators they began to question her competency and long-term effects of her brain injury. Here is a reviewer’s summary of her book published by Outskirts Press, Inc. in Parker, Colorado.

Continue reading "Author from Colorado Springs, CO Relates TBI Difficulties" »

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Traumatic brain injury and spinal cord injury may have another treatment to minimize injury in the future. A biotech company in Maine called Sea Run Holdings Inc. seeks to enter the blood and spinal regeneration markets using salmon-plasma proteins. The effort has been in the works for the last 12 years. One of the efforts by the company is the development of a product that shows promise in the treatment of spinal cord and traumatic brain injury. Product testing has been applied successfully on brain and spine injured animals in suppressing inflammation and pain while even regenerating neurons. The company is looking to move to human clinical trials in the next year. Salmon is rich in Omega 3 fatty acid s that are the basic building blocks for nerve tissue and brain cells. Over the past five years funding has been provided through more than $4 million in grants from the National Institutes of Health and the U.S. Department of Defense.

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A new source for victims of and families suffering from a traumatic brain injury has been added to the web. With funding from the government’s Defense and Veterans Brain Injury Center the public television and radio station WETA created a new website brainline.org that offers victims and their families a user-friendly source of information with one-click access. It offers such online tools as webcasting, videos, a Facebook page, font enlargement, a glossary that can pop up inside text and a one-click option that translates all text into Spanish. The site offers videos from military and sport injury patients as well as those affected by car accidents and other events. The site is aimed at patients and families as well as community health professionals who may have little experience in recognizing or treating brain injuries.

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In an effort to decrease the amount of DUI’s in Colorado the Mothers Against Drunk Driving joined the Colorado State Patrol and Phil Long’s Saturn of Denver on New Year’s Eve to raise awareness of the consequences of driving drunk. MADD asked the public to display MADD red ribbons for the campaign Tie One On For Safety. MADD volunteer and DUI victim survivor Michael Westphale was hit by a drunk driver in 2003 and sustained a traumatic brain injury as well as other devastating injuries. After regaining consciousness from 22 days in a coma, he spent months in the hospital learning how to regain normal functions again. What was especially upsetting for him during his recovery was when his mom had to watch him learn how to take his first steps a second time at the age of 21. Car accidents are one of the leading causes of traumatic brain injury.

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The clinical guidelines for traumatic brain injuries have been revised by a collaborative effort between the American College of Emergency Physicians and the Centers for Disease Control and Prevention. The effort seeks to improve
patient outcomes for the more than one million patients who suffer from a concussion or a mild TBI every year. “People with traumatic brain injuries may appear to be normal and their symptoms may be mild, but there can be hidden dangers,” said Richard Hunt, MD, Director of the Division of Injury Response at the Centers for Disease Control and Prevention. “TBI's can also lead to significant, life-long impairments that prevent a person's ability to function both physically and mentally. These revised guidelines can help ensure that patients with even mild TBI's are identified early and receive the care they need.” It is suspected that that number of TBIs a year is more than the reported million because many victims never get the preventative medical care due to the mildness of the injury and thus the lack of proper diagnosis.

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Ryan, 24, suffered traumatic brain injury when a driver who had been drinking and using amphetamines struck his car head-on in late July. The driver’s Blood/Alcohol level was just under the legal limit for drunken driving. The
crash left Ryan in a semi-coma, unable to speak or control his muscles. His parents watch helplessly by not knowing what the future holds for Ryan and themselves. The driver who caused the head-on was charged with causing great bodily harm while intoxicated with a maximum 12 ½ sentence and a $25,000 dollar fine on November 4th. So where does that leave Ryan and his parents financially in the long term?

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A five-year traumatic brain injury study at 11 health-care facilities in the United States and Canada financed by a $4.3 million grant from the National Institutes of Health seeks to identify the most effective rehabilitation therapies in current use. This research differs from other similar studies in that it will not test experimental treatments. Instead researchers will keep a daily log of the type of care patients receive including speech, physical and occupational therapy. The study will collect detailed records on the type of rehabilitation techniques used on more than 2,300 patients. Dr. James Young of the Rush University Medical Center said, “This is the single-largest and most important study ever done on brain injury and could determine what we're going to do for the next 10 to 20 years. We would love to be able to say objectively that a particular therapy is what makes a difference.” Researchers will analyze the data to determine which components of the therapies were most effective in improving outcomes for patients with different types and severity of injuries. Patients will be followed for a year after discharge to assess their quality of life, including whether they were able to live independently. “What this study allows us to do is get good data and research on a patient population that is incredibly heterogenous and therefore hard to research,” said Emily Poole, a speech and language pathologist at Rush. "Medical fields are moving toward being more evidence-based care. But it's really hard to do with the traumatic brain injuries population, because we haven't had good research to back up our treatment.”

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The plight of a brain injury survivor was illuminated when she was tasered repeatedly by a Norfolk, VA police officer prior to being arrested. Pamela Brown is known locally as the “hula-hoop lady”, a nickname that testifies the extent of her brain injury. Stephen M. Smith, a Hampton, Virginia attorney and founder of The Brain Injury Law Center, which specializes in traumatic brain injury cases, along with Carlton Bennett of Virginia Beach, Va. filed a lawsuit on behalf of Pamela Brown seeking 5 million dollar’s in damages. “Ms. Brown is a brain injury survivor who is regularly seen hula hooping in the area where she was assaulted," said Smith. The suit seeks to compensate Ms. Brown as well as train Norfolk’s officers in understanding traumatic brain injury to prevent this from happening again.

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Colorado Governor Bill Ritter signed an executive order December 8 calling on the Colorado Department of Human Services to administrate the coordination of traumatic brain injury treatment and services across the state. The department will catalog the many tools available to victims and their families. Their effort is a step to connect the available programs and services in such a way as attainable by all. In a news release the state said there are about 5,000 people a year hospitalized with traumatic brain injuries and an estimated 96,000 Coloradans suffer from them. Sue Kirton, office manager for the Brain Injury Association of Colorado, said the executive order will expand another that went into effect in 2000. “With the number of cases growing, there is a new focus,” she said. “This one helps solidify the need for coordination. This will just help the different agencies involved have a closer relationship and will hopefully make the system for people with a brain injury easier to navigate.”

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A five-year-old twin from New Zealand underwent an experimental umbilical cord blood treatment in the U.S. in an attempt to improve her outcome after she was affected with a form of cerebral palsy which left her brain damaged at birth. The little girl’s sister is healthy, but her brain injury has affected her speech, balance and movement disabling her ability to reach healthy milestones such as talking, walking and eating without assistance. The infusion of her umbilical cord blood at Duke University, North Carolina in August has already shown improvements in her recovery. “Just a few days after the procedure her eyes started to look more alert, she lost the unfoc used, dreamy kind of look,” the girl’s father said. “Her arms and legs began to straighten out, and her physical co-ordination improved.” Since her return home to New Zealand she has continued to make progress and is now attending pre-school. Pediatric oncologist Joanne Kurtzberg, who oversaw the girl’s treatment, has re-infused 50 children with their own cord blood for treatment of cerebral palsy and brain injury since 2003. It would appear banking children’s cord blood could have far reaching capabilities for future necessary treatments.

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Saul Raisin was a rising star in the cycling world before a bicycling accident halted his climb during a Tour De France competition. He suffered a traumatic brain injury in which his parents were told the outcome was dim. The road to recovery has been long and difficult, but Saul never gave up. “Looking back 2 1/2 years ago I was in a hospital bed, I couldn't move the left side of my body,” expressed Raisin. “I always believed everything happens for a reason and that purpose would come to life.” The purpose he has found is in helping others in similar circumstances. Saul started a foundation that he hopes to use as a tool to connect families with each other and to let them know they are not alone. He hopes to raise money for research and public awareness about traumatic brain injury. Raisin has wr itten a book detailing his journey on the road to recovery, “I was able to give a copy of my book Tour De Life to every one of the injured troops with traumatic brain injuries at Walter Reed.” Cycling is still Saul’s passion and his continued recovery is an uphill climb.

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Doctor Bruce Battles of Kentucky is convinced that the use of the video game system Nintendo Wii helps victims of a traumatic brain injury to recover. In an effort to prove his claim he has started seven TBI patients playing Wii one hour a day, five days a week, for six months. “Two of our subjects actually went from severe level to moderate,” said Dr. Battles. “Six of the seven showed improved memory.” His study found that half of his patients increased their range of motion and most improved social skills starting with Wii Bowling and Tennis. A patient with a 29-year-old brain injury even improved his short-term memory. “This shows the brain still can function,” said Dr. Battles. “There still can be things to unlock from the brain that we though t were sitting dormant and were never going to work again.” Dr. Battles also believes that those recovering from stroke could benefit, “Not only for the TBI patients involved in this, but potentially for stroke victims in doing so you can recover at a faster rate.” He has been presenting the results of his study around the country.

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The Regional Medical Center at Memphis and researchers from University of Tennessee Health Science Center are overseeing a clinical trial to test the effectiveness of administering concentrated salt solutions in traumatic brain injured patients. As part of the clinical trial concentrated salt solutions will be placed in TBI patients’ veins rather than the standard saline solutions. The intent is to determine whether the concentrated solution could effectively reduce the dangerous swelling of the brain post injury as researchers believe will be the case. The clinical trial is sponsored by the National Institutes of Health.

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Marine Corporal Steven Schultz suffered a traumatic brain injury during his second tour of duty in Iraq. His brain injury has affected his vision in such a way that his brain is ignoring visual input because of a lesion in the visual processing center of his brain and is called hemi-spatial neglect. “Because of the brain injury, I don't see a lot of stuff on my left,” he explained. While walking he will run into people if they are on his left side. Combining an old technology with new at the DeBakey VA Medical Center is helping veterans like Corporal Schultz to regain some of their independence. Doctors at DeBakey say some odd-looking prism glasses help retrain the brains of patients with visual impairments caused by a TBI. Dr. K ia Eldred says wearing the goggles a couple times a day can help a patient correct the hemi-spatial problem. “When they take the glasses off after doing this exercise, they then start being more aware of the left side of space,” Dr. Eldred said. “It's like they're over-correcting back to the left.” Steven has been using them a couple of months and has already noticed a difference. DeBakey low vision therapist Tonya Mennem said, “He (Steven) moved into a new home and he hasn't run into any of the walls and that's incredible progress for him.”

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WETA, the public broadcasting station in Washington D.C. is partnering with the Department of Defense and Veterans Brain Injury Center in launching a website targeted at Traumatic Brain Injury. BrainLine.org is an online effort to centralize core issues on Traumatic Brain Injury such as treatment, prevention and knowledge. The site uses video webcasts, recent research, personal stories and articles on living with TBI to empower victims and their families. More recently on Nov. 7, the site hosted a live webinar featuring former WWE professional wrestler Chr istophey Nowinski. Nowinski is now a researcher for TBI. “Up to this point, much of the information available online was very clinical and difficult to find,” said BrainLine.org executive director Noel Gunther. “We wanted to present valuable information in easy to understand language that anyone -- a service member, a mother, a teenager - could use because these injuries are having a huge impact on a large and growing segment of our country.” BrainLine.org explains what treatment people with brain injuries should receive and what kind of support they will need to begin their altered lives. The website offers resources that provide those living with TBI a 24-hour network of support. The site is located at http://www.BrainLine.org.

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USA Today had an article on the annual meeting of the Society for Neuroscience and reported on encouraging findings scientists have discovered using two types of brain scanning techniques to detect mild traumatic brain injury. Researchers at the University of California in San Diego combined MEG (magnetoencephalography) and DTI (diffusion tensor imaging) to detect brain injury that the traditional MRI (magnetic resonance imaging) and CT had missed. Researchers at the University of Miami used MRSI (magnetic resonance spectroscopic imaging) which is a whole-brain method and is an advanced type of MRI t hat creates images from hundreds of voxels which are three-dimensional units of brain tissue. The MRSI detected widespread damage that sometimes fails to present itself in conventional brain scans. These latest technologies bode well for future victims of mild traumatic brain injury and TBI while the findings are encouraging.

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For parents with an attention deficit hyperactivity disorder (ADHD) affected child or an adult diagnosed with ADHD a link has been found between traumatic brain injury and the incidence of ADHD. Although, researchers stress that an early head injury does not cause ADHD, but instead is associated with a subsequent diagnosis of ADHD. Researchers believe the risky behaviors undertaken by those with ADHD put them in a category of increased risk of traumatic brain injury. Professor Heather T Keenan of the Department of Pediatrics, University of Utah and colleagues reported their findings and published them on bmj.com. Her team studied children who had suffered a head injury prior to two years of age. What they found was those who had suffered a head injury nearly doubled the likelihood of receiving an ADHD diagnosis later in life. In an accompanying editorial, consultant child and adolescent psychiatrist Morris Zwi suggests that this research “strengthens the hypothesis that the ADHD core symptoms of excessive inattention, hyperactivity, and impulsivity might be key factors associated with an increased rate of injury. Primary care clinicians should assess children with injuries for symptoms of ADHD and continue to monitor them over time,” concluded Zwi.

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Our northern neighbors in Toronto has published a study reporting that more than half of the homeless population have suffered a traumatic brain injury and approximately 70% of the injuries occurred before they became homeless. The study was published in the Canadian Medical Association Journal (CMAJ) and is currently the largest such study of its kind globally. The researchers interviewed approximately 900 homeless men and women who frequent Toronto homeless shelters. The study results show a 58% incidence rate of brain injury in homeless men, and 48% in homeless women. This rate is 5 times higher than the U.S. average. According to coauthor Dr. Stephen Hwang of the Centre for Research on Inner City Health at St. Michael’s Hospital in Toronto, the fact that a majority of the interviewees sustained traumatic brain injury before they became homeless suggests a causational link.

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After returning from a trip to Spain seven years ago Heather Payne, 62, started complaining about pain in her leg which was cold and discolored. She was diagnosed with deep vein thrombosis. In surgery, doctors inserted a filter in her neck which caused an internal bleed in her neck which blocked her airway causing heart and lung failure. It took 20 minutes to rive her at which time her brain was deprived of oxygen causing an irreversible catastrophic brain injury. Seven years later, Heather is confined to a wheelchair and suffers from memory problems and epilepsy. Her husband Ron had to take early retirement to care for his wife full time. “I’m just being a husband. Forty-one years ago we said our wedding vows in church and promised to love and care for each other in sickness and in health. That’s just what I'm doing, and I know Heather would do the same for me,” said Ron.

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Diffusion tensor imaging, an advanced form of MRI, is being used by researchers at Weill Cornell Medical College and University of California at San Francisco in studying brains that have undergone a mild traumatic brain injury such as concussion. Often when a patient comes into a hospital after suffering a concussion they undergo a CT or MRI scan and then a basic neurological exam to determine damage. Most are sent home and many patients continue to report symptoms weeks and months later such as loss of concentration or memory loss. What sets the DTI apart is it allows experts to view the microscopic motion of water molecules within the brain’s tissue that connects and allows communication between different brain centers, known as white matter. The research group found that brain injury was visible using DTI in patients’ memory and attention centers of the brain. Further they identified two white matter areas, one associated with attention and the other memory. The research team believes these finding might be the first step toward clinical trials that will determine whether DTI will be effective in early and accurate diagnosis in patients afflicted with a TBI.

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For the life of one little boy and his mother things may be looking up. During delivery James Monroe, born in 1995, head was lacerated by a scalpel. Medical professionals attempted to staunch the bleeding for over an hour; he was transferred to another Hospital and was left with a brain injury. More than four years later his mother decided to file a medical malpractice lawsuit. The lower court dismissed the mother’s birth injury suit because of a statute of limitations. However, the statute also allows for malpractice lawsuits involving “brain damage or birth defect, the period of limitations is extended until the child attains 10 years of age.” The Nevada Supreme Court overruled the lower court’s dismissal of the case, indicating that the injury does qualify as brain damage or a birth defect under Nevada law and the case will be allowed to continue.

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The same drug that has been misused as a performance enhancer illegally is now at the center of the world’s largest traumatic brain injury study. Erythropoietin or EPO has been used in endurance athletes including some cyclists in the Tour de France, long-distance runners, speed skaters, and cross-country skiers. EPO has been banned by the Tour de France, the Olympics, and other sports organizations. However, a study in Australia hopes to use its red blood cell promotion in accident and assault victims with severe brain damage. Recent discoveries have found the hormone EPO can protect brain cells. Starting next year almost 600 severe traumatic brain injured patients in 42 Australian hospital ERs will be involved in the study usin g a synthetic version of the hormone. Professor Rinaldo Bellomo hopes EPO will work wonders for brain injuries, “If the drug proves to be effective, it could mean the difference between a young man sitting in a nursing home with a tube down their nose and being totally dependent on others . . . or the same young man being perhaps slightly weak down one side or having an uneven gait but being able to catch a train to work and lead an independent near normal life,” he said.

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At 9 months old Terry McGowan was dropped from a two-story apartment and suffered a traumatic brain injury. His TBI was further complicated by an adverse reaction to the smallpox vaccine at 18 months. This young man was dealt a bad hand of cards early in life, but has created an environment that he can operate fairly normal in. McGowan has difficulty paying attention, suffers from depression and impaired short-term memory. At home he uses two large whiteboards to remind him of appointments, phone calls, etc. “Sometimes I have to retrace my steps to make sure there is nothing burning, hanging, or blinking,” he jokes. He has also contracted temporal epilepsy that causes him to suffer seizures ranging from grand-mal e vents to relatively painless ones that happen while he is in mid-conversation. Even with the adjustments he has made in his life while living with a TBI, he still has difficulty with day-to-day activities. “When you have brain injury, you tend to be isolated, depressed and you don’t eat enough,” McGowan said. “It’s hard for people to understand.”

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A ground-breaking computer system has been created for victims of traumatic brain injuries who are unable to speak or move. The system devised by computer researcher Dr. Paul Gnanayutham at the University of Portsmouth uses the power of thought and a laptop with sophisticated algorithms. The system uses patients’ brain waves and eye and muscular movements (called bio-potentials) to more a cursor on a computer. In an interview he said, “This technology has been around but very few people have used it for anything worthwhile, I worked with traumatic brain injured participants who were paraplegics, non-verbal and tube fed to give them a voice and the ability to say ‘yes’ or ‘no’ on a computer screen by using their bio-potentials. Learning how to navigate using their facial muscles or brainwaves isn’t easy and can take months. I worked for eight months with one young man who hadn’t communicated after his brain stem was broken in an accident. His mother knew he was ‘there’ and wasn’t giving up on her son but there had been no sign, no movement, nothing until he started using the brain wave system. The system works by attached probes worn around the head that pick up signals from the patient’s body. The signals are then sent to an amplifier that cuts out external noise and then to a serial port so the computer just sees the brain-body interface. The potential for such a system is enormous, but it will be limited to few TBI patients until Dr. Gnanayutham receives more funding. “I want people to be able to use it without doctors and without me. I want to give them their voice back. Only then will it be a real success,” he concluded.

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A ground-breaking computer system has been created for victims of traumatic brain injuries who are unable to speak or move. The system devised by computer researcher Dr. Paul Gnanayutham at the University of Portsmouth uses the power of thought and a laptop with sophisticated algorithms. The system uses patients’ brain waves and eye and muscular movements (called bio-potentials) to more a cursor on a computer. In an interview he said, “This technology has been around but very few people have used it for anything worthwhile, I worked with traumatic brain injured participants who were paraplegics, non-verbal and tube fed to give them a voice and the ability to say ‘yes’ or ‘no’ on a computer screen by using their bio-potentials. Learning how to navigate using their facial muscles or brainwaves isn’t easy and can take months. I worked for eight months with one young man who hadn’t communicated after his brain stem was broken in an accident. His mother knew he was ‘there’ and wasn’t giving up on her son but there had been no sign, no movement, nothing until he started using the brain wave system. The system works by attached probes worn around the head that pick up signals from the patient’s body. The signals are then sent to an amplifier that cuts out external noise and then to a serial port so the computer just sees the brain-body interface. The potential for such a system is enormous, but it will be limited to few TBI patients until Dr. Gnanayutham receives more funding. “I want people to be able to use it without doctors and without me. I want to give them their voice back. Only then will it be a real success,” he concluded.

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http://www.burgsimpson.com/brain.htmlBret DeFrancesco suffered multiple injuries in the Iraq war caused by a roadside bomb, including Post Traumatic Stress Disorder but the one he is currently rehabilitating for is his brain injury. DeFrancesco suffered a traumatic brain injury which disrupted his sense of balance. When he jogged he suffered motion sickness and going up and down stairs became a nightmare. As part of his rehabilitation the Fort Lewis soldier attended physical therapy once or twice a week at MultiCare Health System’s Vestibular Balance Clinic in Tacoma, Washington. “These appointments don’t solve everything,” he said during his final visit to the clinic, “but they’re helping a lot.” Karen Perz was his physical therapist. “They say my vertical line – what I consider my vertical line – is canted,” he said “It’s never going to get fixed. You need to retrain your mind.” Perz says treatment requires training the brain to recalibrate its sense of balance. “The brain is hardwired to work as though everything is normal,” she explained. “When something becomes not normal, part of what we do is train the brain to work around so the outcome is normal even though the brain circuitry isn’t normal anymore.” After Perz’s physical therapy some TBI sufferers can completely recover their balance. However, for those who don’t she teaches them drills to practice the rest of their life. “The longer someone works at it,” she said, “the more efficient the brain will become using the information correctly.” DiFrancesco drills included wearing safety goggles with a piece of white paper taped to the front with small eyeholes punched out. Perz would hold up a sign and tell the soldier to focus on a letter, close his eyes, turn his head, open his eyes and see if he could focus on the same letter. Perz called it “relearning where his head is relative to his body.” One exercise, in which he walks forward while moving his head while focusing on a point, is the drill Perz said he “gets to do the rest of his life.” He has come a long way since he first started going to the clinic. He knows that the TBI will affect him the rest of his life, but he is please by the progress he has made. His nausea has decreased considerably since the rehabilitation and he looks forward to getting back to work. He wants to stay in the Army and maybe eventually transfer to an aviation unit. “I know I’ve got work ahead of me,” he said. “I’ve got to keep working at this stuff. I still have PTSD and TBI. But I still feel like I’ve got more I can give.”

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a story about doctor becoming patient, neuroradiologist Wade Justice was a victim of a traumatic brain injury caused by a drunk driver. Dr. Wade Justice and his wife were on a scenic Big Island drive 3 ½ years ago when they were hit by a drunk driver. He shared his story at the recent Neurotrauma Conference sponsored by the Brain Injury Association of Hawaii. Dr. Geoffey Manley, chief of neurosurgery at San Francisco General Hospital, told the conference members that the traumatic brain injury classification of mild, moderate and severe is outdated and must be changed. It is like saying people have "OK cancer, bad cancer or they're at death's door," he said. Neurotrauma ranges from a concussion to a severe brain injury, "and we still don't understand concussion." At the time of Justice’s accident he was taken to a local hospital with an epidural hematoma. His wife Jill said the doctors did not believe he would last the night and to bring their children from their Washington home to say goodbye. “Wade absolutely would have been dead if we hadn't had a strange coincidence,” she said. “We were able to fly him directly out of Waimea Airport that night.” Normally, he would have been transported to Hilo or Kona, and he would not have survived another 40 minutes, she said. At about midnight a neurosurgeon was able to provide lifesaving surgery, but he remained comatose for another month and nearly died three more times. After being transported from hospital to hospital, Justice was finally flown to Craig Hospital in Denver for an assessment and rehabilitation plan. At one point after the accident when he could not walk or talk, he said he felt suicidal but decided "I can't just check out on the people I love. I've got to keep trying." Justice underwent extensive occupational, physical and speech therapy and treatment from a neuropsychologist. The traumatic brain injury expectedly has changed their lives forever. Their story is like millions of others. Traumatic brain injury cuts across all classes, races and income levels. It holds no prejudice. They were lucky, but thousands of others are not so fortunate.

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One of the little known side effects of Traumatic Brain Injury is spreading depression. Those of us without a brain injury think of this as a change in mood and behavior, but what TBI victims are facing is depression in the brain. When the brain is injured traumatically by a blunt force trauma or shearing “spreading depression” refers to the shutting down of electrical activity in the brain. According to Dr. Jed Hartings, a neuroscientist and U.S. Army veteran, the “spreading depression” occurs in almost every brain injury and, “seems to impact gene expression, blood flow, metabolism, all of which can be very harmful to the tissue.” Hartings and a group of researchers recently received a $2 million grant from the pentagon to conduct a trial for treatment of “spreading depression” in TBI. As part of the trial, doctors will place tiny electrodes on the surface of the brain to record brain activity post surgery. “Our hypothesis is that spreading depression causes expansion or enlargement of the brain injury, so our ultimate hope is that we can improve patient outcomes, improve the recovery from brain injury, by preventing spreading depression.” The researchers believe that anti-seizure medications could prove useful in stopping this side effect of TBI. Results of the trial are not expected for at least a couple of years.

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A former resident of Colorado was a recipient of a certificate of recognition award from vice presidential candidate and Alaska Governor Sarah Palin for his efforts in raising public awareness of Traumatic Brain Injury. When living in Colorado he suffered a traumatic brain injury as a result of a motorcycle accident shortly after graduating high school. Richard Warrington now lives in Kenai, Alaska. Now at 48 he attributes much of his rehabilitative success to the therapists at Craig Hospital in Denver and to his mother. In 1986 Richard moved to Alaska and learned the state had no support network for survivors of a traumatic brain injury similar to the type of network he depended on in Colorado. As a result he helped start a Kenai Peninsula brain injury support group. “I started giving presentations (on traumatic brain injury) through the Alaska Mental Health Trust campaign in 1996,” said Richard, and at the same time, he and his wife Mary began making the presentations to students in middle schools and high schools around the state. The couple advocates the wearing of helmets when cycling, riding all-terrain vehicles, snow-mobiling and other outdoor recreational activities. Their latest recognition certificate, signed by Governor Sarah Palin, is special. “We were up at the Alaska Brain Injury Network Board meeting (in Anchorage), and they started reading the certificate,” said Richard and unbeknownst to them the presenter announced Richard Warrington. Richard and Mary have also received the educator award from the Alaska Chapter of the American Red Cross in 2004, and were appointed ambassadors by the Brain Injury Association of America in 1996.

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An unusual story will be featured on the Discovery Health Channel in the show “Mystery ER” featuring a woman who suffered a traumatic brain injury and developed a foreign accent after a failed chiropractic adjustment. The show features real life medical mysteries using subject interviews and re-enactments of true events. The show will feature CindyLou Romberg who suffered a traumatic brain injury after falling out of the back of a Toyota in 1981 and splitting her head open from front to back. What makes Romberg’s recovery unusual is after a more recent failed chiropractic adjustment she developed a foreign accent described as sounding German, French or Russian and yet she has never studied the languages nor visited the countries. Foreign Accent Syndrome is a rare disorder brought on by neurological damage that affects a person's ability to speak and creates the impression of a foreign accent. Without warning Romberg’s accent changes. Sometimes she can’t remember the name of an object and has to gesture at it. At other times incoherent babbling is spoken. Only 50 or 60 Foreign Accent Syndrome cases have been verified worldwide. Typically, neurological damage generally in the brain's left hemisphere is followed by the inability to use words properly or at all, then a gradual return of speech, albeit altered. Most cases develop within one or two years of the original injury. Jack Ryalls, an expert on neurologically based speech disorders at the University of Central Florida believes the FAS could be a recovery stage, the brain’s way of compensating for lost function by rewiring.

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Neuroscientists at Arizona State University have found a new treatment for brain disorders such as Traumatic Brain Injury and Alzheimer’s. In an article in the Oct. 29 issue of the Journal Public Library of Science they reported they have developed pulsed ultrasound techniques that remotely stimulate brain circuit activity. “We were quite surprised to find that ultrasound at power levels lower than those typically used in routine diagnostic medical imaging procedures could produce an increase in the activity of neurons while higher power levels produced very little effect on their activity,” lead investigator William “Jamie” Tyler said. The findings are encouraging. If the noninvasive ultrasound technique proves helpful in the treatment of TBI then the door this treatment opens for victims of TBI is significant. Tyler and the other ASU researchers will now focus on further research into the influence of ultrasound on intact brain circuits and hope to use the low intensity ultrasound in pre-clinical trials for the treatment of neurological diseases.

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InfraScan Inc. recently received approval for its handheld brain hematoma detector from the European Union. InfraScan developed the device to assist first responders and emergency room personnel in detecting traumatic brain injuries. A quick assessment of patients with a potential traumatic brain injury greatly increases patient outcomes if treated within an hour of the injury. While technology exists such as Computer Aided Tomography (CAT), many hospital facilities lack the neurological capabilities to treat TBI. Therefore, if first responders are in possession of a device such as InfraScan’s they can determine which hospital to send the patient to that will best treat the TBI. The device is small and portable and can detect the presence and location of a brain trauma based on differential NIR light absorption between the brain trauma and uninjured brain tissue. InfraScan will present the results of a 400 patient multicenter study to the FDA later this year and hopes to launch use of the device in the U.S. shortly thereafter.

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As an effort to keep medical consumers apprised of the latest advances in potential medical answers to tough medical issues, it is with interest that we inform readers of a new treatment for Traumatic Brain Injury that is peeking on the horizon. After a positive meeting with the U.S. Food and Drug Administration, Oxygen Biotherapeutics, Inc has announced that it will expand its clinical trial plan for its perfluorocarbon therapeutic oxygen carrier and liquid ventilation product called Oxycyte in the use of Traumatic Brain Injuries. Patient enrollment is anticipated to begin in the first quarter of 2009. The study will be conducted in the United States with and additional trial planned for Canada and possibly Switzerland. The clinical trial will ascertain the correct dose of Oxycyte to affect a better outcome for patients on the Extended Glasgow Outcome Scale (EGOS). The EGOS is a scale determining the level of disability a TBI patient has incurred. Both the U.S. and Canadian studies will be multi-center studies focusing on finding the lowest dose that reduces thrombocytopenia (having fewer than normal number of blood platelets per unit volume of blood associated with hemorrhaging) and still provide clinical benefit in traumatic brain injury. “This gives us a more efficient way to advance our clinical trials. It is extremely important to bring Oxycyte another step forward because we have a level of obligation to TBI patients and their families," said company chairman and CEO Chris J. Stern, DBA. "Right now there is no medical treatment for TBI patients and mortality is 20 - 25 per cent. Additionally, of those that survive, half are unable to return to the lives they had before their injury. The procedure in the dose escalation studies is designed to find the safest dose level of our drug and to bring it to market in due course. These dose escalation studies are the foundation to move to the next step of enrolling and treating TBI patients and showing what Oxycyte can do to help them recover and lead normal, productive lives.”

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At four years old Jordan Boyd’s life and the life of his family changed forever. He was at a neighbor’s house getting his haircut for his birthday party. When someone shouted that his birthday friends were arriving he ran across the street and was struck by a speeding vehicle. Jordan remained in a coma for four months and was hospitalized for ten after sustaining a traumatic brain injury. Jordan is now 22 he has difficulty walking and talking and has minimal use of his arms and hands as well as legally blind. Tragedies such as this are happening all over the United States daily and yet many remain in the dark about the devastating life-altering consequences. “I had no idea what a brain injury meant,” said his mother, Joanna Boyd. “Nobody should have to learn about brain injury the way I did, in an intensive care unit. Brain injury is a life-altering experience for everyone.” The Brain Injury Association of New Jersey has been a lifeline for Joanna Boyd’s family. On Oct. 18, Jordan will join hundreds in the 2008 Walk for Thought/Cycle for Safety event held by the Brain Injury Association of New Jersey. Jordan will be riding in honor of his 21 year-old friend who had a brain injury and passed away this summer. The statewide event raises much-need funds for services, increases public awareness, celebrates the achievements of people living with a brain injury and honors those who have suffered a TBI, but cannot walk in the fundraiser.

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An Irish teenager suffered permanent brain damage when he received excessive doses of an experimental drug used to treat leukemia. A high dose of Methotrexate, a toxic drug used for cancer treatment, was administered intravenously as well as 14 additional injections into the boy’s spine over a nine-week period that allegedly led to neurological injuries. According to the protocol of treatment the correct dosage in the same period of time should have been six and not 14 injections. The excessive amount caused neurological brain injury and the boy now has the intellectual capacity of a 7-8 year old. He will require round the clock care the rest of his life. The 14 year-olds parents brought a claim of negligence against the hospital and the oncologists who treated him. The claim was settled for 2.7 million Euros, plus costs. The judge, who approved the settlement, was told the case was settled after "protracted negotiations". The settlement will help his parents care for him the rest of his life.

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CORE Health Care in Texas is a provider of treatment for individuals with brain injuries and psychiatric disorders. CORE has developed a unique instructional DVD and manual called the CORE Family Trainer that is designed to train families in how to interact with those who have suffered a brain injury. “We receive calls from families across the country looking for resources, some sort of guidance to help them understand the changes in their loved one with a brain injury and how to effectively communicate with them,” Eric Makowski, CEO of CORE Health Care and president of the Brain Injury Association of Texas, said. “We scoured the country but found that there was no such tool in existence, so we created it.” The DVD and manual packet provides role-playing opportunities that illustrate the common problems friends and families face at home while interacting with their loved ones who have suffered a brain injury. The tools offered through the DVD and manual based in research and are well established principles of treatment found in rehabilitation facilities across the country. To order the DVD, visit http://www.corefamilytrainer.com or call 866.683.1007.

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In a recent study of homeless people in Toronto, Canada’s shelter system it was found that 58 percent of homeless men and 42 percent of homeless women had a history of traumatic brain injury. Even though they were homeless, they each had health insurance. In the study, published in the Canadian Medical Association Journal, of more than 900 homeless in Toronto it was found that health problems included an increased risk of seizures, mental health problems, drug abuse and poor physical health status. Dr. Stephen Hwang, a physician and research scientist at St. Michael's Hospital stated that for many the first instance of traumatic brain injury often occurred at a young age and “suggests that in some cases TBI may be a causal factor that contributes to the onset of homelessness, possibly through cognitive or behavioral dysfunction caused by a TBI.” The implications of these findings should enlighten those providing health care to homeless people that the difficult behaviors they may sometimes face could in fact be a result of a TBI. Further, encouraging the health care providers to ask their patients if they have suffered a TBI and if so to offer neuropsychological screening, referrals to rehabilitation programs and other community support systems, wrote the authors of the study.

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Deep brain stimulation is already used to treat Parkinson’s disease and is now being tested in patients with traumatic brain injuries as well as a number of other medical and emotional problems. “I believe this field is where heart pacemaker devices were 25 to 30 years ago. Brain pacemakers are going to have a significant impact on the treatment for a number of neurological and behavioral conditions,” said Dr. Ali Rezai, director of the Cleveland Clinic's Center for Neurological Restoration. Researchers are using new brain maps generated by sophisticated imaging technologies such as functional MRIs and PET scans. By recording activity in both sick and healthy people, scientists are learning how brain circuits work and discovering where significant breakdowns seem to occur. In a successful effort, a year ago researchers in New York and New Jersey reported that a minimally conscious man in a nursing home who appeared unaware of his surroundings began speaking single words and responding to people after treatment with deep brain stimulation occurred. Dr. Nicholas Schiff, a neurologist at Weill Cornell Medical College believes the procedure may have activated neural circuits that were intact but impaired after an assault disabled the 38-year-old man. His team has received approval from the Food and Drug Administration to study 11 additional patients with traumatic brain injury.

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Research is finding that mild traumatic brain injuries (MTBIs), or concussions, are much more common than previously thought in children. A mild traumatic brain injury can result from a direct or indirect blow to the head and from an impact somewhere else on the body where the impelling force is transmitted to the head, such as in a sudden stop. It is now estimated that more than 1 million children a year experience an MTBI, and some studies suggest that number may actually be closer to 3 million to 5 million children a year. In the United States these injuries are responsible for 2,700 deaths a year, 37,000 hospitalizations, 435,000 emergency room visits, and more than 125,000 visits to the pediatrician. Concussions occur when the cerebrospinal fluid surrounding the brain is insufficient in cushioning the brain during an impact. As a result, the brain can slam against the interior of the skull. Symptoms of a mild traumatic brain injury include changes in physical, cognitive and emotional functioning. Physical symptoms express themselves as loss of consciousness, headaches, ringing in the ears, slurred speech, fatigue, dizziness, light sensitivity, nausea/vomiting, problems balancing and visual impairment (blurred or double vision). Disturbance in cognitive functioning such as memory loss, trouble focusing and feeling “foggy” can occur as a result of a MTBI. Recent research has highlighted the emotional difficulties faced that present themselves as irritability, sadness, anxiety and increased emotional sensitivity. In adults who have suffered a number of MTBIs there was a strong correlation between the brain injuries and chronic depression which has presented itself as suicidal tendencies. With all the information that research has found on concussions and traumatic brain injuries it is imperative to seek medical help to prevent further brain injury and dysfunction. Rest is necessary for in all cases.

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While riding his bike an Omaha, NE father and husband suffered an epileptic seizure. When his head hit the pavement he suffered a traumatic brain injury, ultimately losing two-thirds of the left hemisphere of his brain. He was not wearing a helmet at the time. He underwent intensive therapy at a rehabilitation center, but his doctor said his memory, judgment and reasoning are still lacking. The man says he feels fantastic and looks forward to returning to work and driving again. However, his wife and doctor disagree. A psychologist said brain injury patients often experience denial about their injury and how it will affect their life. Although the goal of rehabilitation is to help brain injury patients return to some level of independence, unfortunately it isn’t always successful. Many state brain injury associations have resources available to the families and victims of a traumatic brain injury. The Brain Injury Association of America is an excellent place to start looking for options.

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According to the National Center for Injury and Prevention falls are the leading cause of Traumatic Brain Injury (TBI). A TBI is caused by a blow to the head that does or does not penetrate the skull in a head injury. Falls lead the statistics with 28% of the pie. Motor vehicle accidents have 20% of the portion and 19% are caused by a blow caused by a strike to the head. TBI rates in children ages 0-4 year and adults 75 and older, falls are the highest cause of TBI. Motor vehicle accidents result in the greatest number of TBI-related hospitalizations and are highest among adolescents aged 15 to 19 years old. A strike to the head by collision with a moving or stationary object are the third leading cause of TBI resulting in approximately 1.6 to 3.8 million sports and recreation related TBIs in the United States each year of which most are mild and are not treated in a hospital or emergency department. These statistics highlight a frightening picture of the disparity in the amount of children compared to adults who are at risk of a TBI. All too often a child’s TBI is due to the negligence of another person or business; i.e. birth injuries, bicycle collisions, etc. A helmet sometimes can only go so far in protecting the skull and brain of a child. In these types of cases the child and their family have legal recourse and can seek compensation associated with a TBI. Depending on the severity of the injury, the amount of damages can be quite significant because of the cost of long term care and the inability of the child to earn financial emancipation over his or her lifetime.

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A lawsuit has been filed with the San Diego Supreme Court seeking unspecified damages on behalf of high school football player Scott Eveland, who suffered a catastrophic brain injury allegedly by the delay of an emergency response team. The family hopes the litigation process will bring to light why a second ambulance had to be called to transport Eveland even though one was currently on site. “To have the ambulance there and refuse to transport certainly was not in Scott's best interest,” attorney David Casey Jr. said. “Our main focus right now is to understand this policy.” Casey said Eveland, who collapsed during the second quarter of a game on Sept. 14, 2007, has permanent brain damage and will require constant care for the rest of his life. “When you have bleeding in the brain, you know, every second counts,” Casey said.

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During the week of October 20 the U.S. Food and Drug Administration will meet with the biomedical company Oxygen Biotherapeutics, Inc. to discuss any remaining issues the agency might have with their therapeutic oxygen carrier, Oxycyte®. Oxygen Biotherapeutics proposes to continue use of Oxycyte in a Phase IIb clinical trail in Traumatic Brain Injury. “At that meeting, we will be extensively prepared to resolve any remaining issues and concerns the FDA may have,” said company chairman and CEO Chris J. Stern, DBA. “We view this as a positive development, as the agency has also offered to review the Company's overall development plan. This may contribute to reducing regulatory risk at future stages such as Phase III. We will constructively use the dialog and its documentation process to align the clinical and non-clinical development plan for TBI with potential endpoints for Phase III and towards an eventual registration.” The company's planned multi-center, double-blind, placebo-controlled study would enroll up to 300 patients. 200 patients will be allowed for enrollment through a $1.9 million grant from the United States Department of Defense to M. Ross Bullock, M.D., Ph.D., of the University Of Miami Miller School Of Medicine, Department of Neurosurgery. Dr. Bullock is the principal investigator for the planned Phase IIb clinical trial. The clinical trial date will depend on the outcome of the FDA review process.

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St. Louis University researchers are beginning a study that’s focus is to improve treatment of brain injuries for civilians and combat veterans funded in large part by a $5.3 million grant from the Department of Defense. They will be using advanced imaging technology to create better maps of the brain in an effort to develop therapies that target areas of the brain that retain function, but are unable to communicate with the rest of the brain. Researchers will examine 200 people with brain injuries and use a control group of people with uninjured brains. The study participants will undergo three types of imaging tests, as well as neuro-cognitive testing. The resultant data will be a compilation of how a patient's brain is working. SLU researchers have access to three types of imaging equipment a 3 Tesla MRI, 64 Slice PET/CT and MEG (magnetoencephalography) The MEG is an unusual and vital imaging technique that is used in only a handful of facilities. After a traumatic brain injury some regions of the brain continue to function, but if the neural pathways are destroyed the brain in unable to communicate with the rest of the body. As little as 10 years ago, scientists believed that a TBI caused irreversible damage, but have since learned that the brain can remarkably rewire itself. Researchers hope the compiled data will assist in quantifying levels of injury, diagnosing injuries faster without advanced imaging equipment and determine which patients will benefit the most from rehabilitation.

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Over the last decade brain research and technology have multiplied. Posit Science Corporation is one of the companies who done extensive research into brain injuries and base there treatments on neuroplasticity, the brain’s ability to reconnect neurons through intensive, repetitive and progressively challenging activity. Posit works with more than 50 brain scientists from leading universities around the world to create training programs that enhance cognitive performance. “Many believe that we have already entered the 'Cognitive Age,' where the greatest value we create comes from what we know,” observed Posit Science Chairman and CEO Jeff Zimman. “In the next few years, newly developed technologies that actually enhance cognitive abilities will not only create our greatest gains in personal productivity, but will also be critical in addressing a host of public policy challenges.” Scientists visiting the U.S. Senate believe that recent breakthroughs in brain research and technology will have a great impact on public policy issues. The Senate Committee on Health, Education, Labor and Pensions (HELP) invited the researchers to the Senate. Scientists summarized more than 30 peer-reviewed papers emphacizing the power of cognitive training technologies and offered hands-on demonstration of products using those new technologies. “Recent studies show that the right cognitive training exercises can improve processing speed, accuracy, attention and memory in older adults,” Dr. Mahncke continued. “Most recently, we have learned that this can be done in ways that generalize to everyday life and persist after the training ends. These gains are large -- roughly equivalent to a reversal in the normal decline we see over a decade in an average person over age 50.” This is an important advancement for those in the public domain that our U.S. Senate is taking notice.

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Eight years ago a class-action lawsuit was launched against drug manufacturers Warner-Lambert Co. and Parke-Davis regarding their diabetes drug Rezulin that was found to have caused severe and sometimes fatal medical issues in those who took it. In December 2007 County Circuit Judge John Hutchison approved a $17.1 million settlement agreement. A number of individuals eligible to receive damages did not claim their money which resulted in a surplus of nearly $8 million in unclaimed monies. The unique settlement arrangement allowed for the unclaimed money to go to diabetes treatment and research in West Virginia. Two orders signed by Hutchison last Wednesday awarded $2.25 million to the Marshall University Joan C. Edwards School of Medicine Rural Health Program and $5.67 million to the West Virginia University Department of Pediatrics. Marshall’s funds will be used to help its diabetes center promote better treatment of diabetes issues and add a new focus on diabetes and related disorders to its mobile medical center, which travels around the state performing cancer screenings in rural areas. West Virginia University will use the funds to research a possible link between obesity, diabetes and asthma in the state’s children. Hutchison commended the efforts of both lawyers in the case saying, “I believe the plan for the distribution is an outstanding example of cooperation between the two parties involved, and the distribution is absolutely in the best interest of the citizens of the state of West Virginia.” he said.

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In the August 13, 2008 edition of the Journal of the American Medical Association a study titled “Prevalence of Chronic Pain after Traumatic Brain Injury” was submitted. Dr Charles W. Hoge, of Uniformed Services University of Health Sciences (USU) was the author of the study. USU is the nation’s federal school of medicine and educates health care professionals who are in service to the Department of Defense and the U.S. Public Health Service. The study was a compilation of 23 studies using 4,206 veterans of the Operation Iraqi Freedom and Operation Enduring Freedom questioning veterans 3 to 4 months post return to stateside. Dr. Hoge reported that chronic pain is a common complication of TBI and is not associated with psychologic disorders such as PTSD and depression. Surprisingly, chronic pain was also found to be common among patients considered to have sustained a minor brain injury as well.

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In a study appearing in the September 9th release of Neurology researchers reported that even though someone may have recovered well from a traumatic brain injury based on cognitive tests, the patients often report mental fatigue and not quite feeling the same as they did prior to injury. The brains of people who've recovered from head injuries have to work harder than the brains of healthy people to perform at the same level, said researchers at the Rotman Research Institute at the Baycrest Centre for Geriatric Care, in Toronto. Functional MRI was used to assess brain activity in those recovered from brain injury and compare it to individuals who have not suffered a TBI. The eight patients in the study suffered diffuse axonal injury (DAI) most commonly caused by falls, motor vehicle accidents and injuries where the brain is violently shaken inside the skull resulting in the widespread disconnect of brain cells. “Our imaging data revealed that DAI patient brains had to work harder to perform at the same level as healthy, non-injured brains. Specifically, the brain injury patients showed a greater recruitment of regions of the prefrontal cortex and posterior cortices compared to healthy controls,” study leader Dr. Gary Turner said in a Baycrest news release. The researchers hope their findings will help in the development of future treatments that ultimately improve their cognitive abilities.

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The Brain Injury Association of Colorado holds an annual Pikes Peak Challenge to benefit survivors of traumatic brain injuries. The fundraising event is held annually in September and includes a hike to the summit of Pikes Peak in Manitou Springs after a 13 mile ascent. Funds raised by the Pikes Peak Challenge helps provide direct services to two thousand survivors, families and professionals annually. Several thousand more are served through community outreach programs. Programs include support groups, community education and prevention, the Outdoor Adventure Challenge, volunteer programs and more.

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According to the Centers for Disease Control and Prevention the fall-induced traumatic brain injury death rate for people 80 and older increased by 60 percent between 1989 and 1998. Further, seniors who have fallen previously or who stumble frequently are two to three times more likely to fall within the year. The risks increase if you are a white female who has fallen previously or have lower body weakness, vision problems, or are taking more than four medications. In an unusual study, researchers from the School of Podiatric Medicine at Temple University found that females aged 65 or older can benefit from a specific form of Yoga called Iyengar. The yoga program used chairs and other props to help with body placement. After the nine-week program researchers found that participants had a faster gait, increased flexibility, improved single-leg stance and an increase in confidence in walking and balance. A profound difference in how weight was distributed on the bottom of the foot helped maintain balance. Jinsup Song, D.P.M., Ph.D., Director of the Gait Study Center at Temple University School of Podiatric Medicine, says, “People are gaining more confidence as they stand and walk at the end of the yoga intervention. People are more aware of their body posture. It [yoga] opens up a whole range of treatment options we didn’t think we had before.”

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Recovering from a traumatic brain injury is a long and hard process of rehabilitation and dedication. It can take years to gain just a little bit of what was lost in memory and physical and mental disability. It’s important to explore all options and find a team of supporters that will work diligently in the brain injured favor. Don’t take “no” for an answer. Complete recovery may not be possible, but with a team composed of doctors, psychologists and family who are dedicated to rehabilitation much of what was lost can be recovered. In fact a Pennsylvania woman who was struck by a truck while riding her bicycle in 2005 suffered severe brain injuries. She spent two weeks in a coma and endured several surgeries and extensive rehabilitation. Three years later she competed in an Ironman competition. In her own words, “I'm high functioning as described by neuropsychologists, but I'm about 80-percent of my capabilities and working hard every day to try to overcome that and get back a normal lifestyle.”

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At the University of Texas Health Science Center researchers have been given FDA approval to study a new rapid cooling device in a clinical trial for patients with traumatic brain injury. Life Recovery Systems’ ThermoSuit(R) System was approved for clinical study under the Investigation Device Exemption by Dr. Guy Clifton at U of T. The study will attempt to determine if the induction of hypothermia in three intervals at 2 and a half hours, four hours and maintained for 48 hours after severe traumatic brain injury will result in an increased number of patients with positive outcomes at six months and twelve months post injury. A previous study performed by the same researchers indicated that later cooling was ineffective in reducing brain injury side effects. “If the study proves to be successful, the ThermoSuit System could potentially benefit thousands of patients with traumatic brain injury,” said Milton Frank, Life Recovery Systems' COO. “Traumatic brain injury is the 'signature wound' of the Iraq war, and LRS is hopeful that early cooling will be beneficial to a number of military casualties.” The study will employ 240 patients and is entitled the National Acute Brain Injury Study: Hypothermia IIR and is being sponsored by the National Institute of Neurological Disorders and Stroke.

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A new study found that traumatic brain injury patients may have to employ more of their brain power than they did before their injury to perform the same tasks prior to injury. Researcher Dr. Gary Turner said, “Specifically, the brain injury patients showed a greater recruitment of regions of the prefrontal cortex and posterior cortices compared with healthy controls.” The brain injured participants in the study showed increased activity in different parts of the brain than the uninjured control group. In addition, they said, because traumatic brain injury is often associated with chronic pain, depression, and anxiety, “it is plausible that any reduction in neural processing efficiency resulting from brain injury may be exacerbated by secondary impacts of comorbid physical or psychological impairments.” In other words, further physical or mental trauma to the head may delay recovery.

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The cancer drug Bryostatin has been shown to repair brain tissue if it is given within 24 hours after a stroke, according to U.S. researchers. This could have far reaching significance for those who have suffered a traumatic brain injury. In an article published in the latest issue of the Proceedings of the National Academy of Sciences, it was described how Bryostatin repairs and improves memory. In animal tests the drug rescued dying neurons, stimulated the growth of new neuron connections and restored memory. The researchers have asked the U.S. Food and Drug Administration if they could begin clinical trials of the drug. This could be an important and ultimately successful treatment for the estimated $1.9 million who have suffered from some type of brain injury.

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The America’s Heroes at Work Web site ( www.AmericasHeroesAtWork.gov) has been launched by the U.S. Department of Labor for use by employers who hire veterans that have suffered a traumatic brain injury and/or post-traumatic stress disorder. The web site includes tools and guidance on how to implement accommodations and other services at the workplace. As well as a toll-free number where employers can call to receive assistance relating to workplace accommodations for veterans with disabilities. The site is also a reservoir of job coaching and mentoring programs. The site seeks to help and encourage employers in their endeavor to not only assist veterans, but to help non-veterans who have suffered TBI and PTSD. America’s Heroes at Work is managed jointly by the Department of Labor’s Office of Disability Employment Policy and Veterans’ Employment and Training Service, in collaboration with other federal agencies engaged in TBI and PTSD programs, including the Department of Defense, the Department of Veterans Affairs, the Department of Health and Human Services, the Department of Education, and the Social Security Administration.

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Traumatic brain injury used to be associated with a blow to the head, but recent awareness of the injury brought by soldiers returning from wars indicates otherwise. Improvised Exploding Devices or IEDs may not touch a soldier, but the resultant pressure of the explosion can cause a sheering to the tissues in the brain. Regardless of how the injury is experienced the symptoms share a common factor; they interfere with the way the brain works. Neurosurgeon Dr. Jeffrey Crecelius recently wrote an article on the prevention of concussions which are a type of traumatic brain injury. Brain injury can affect memory, judgment, reflexes, speech, balance and coordination. Even though a concussion cannot be seen keep an eye out for the symptoms which can show up days or weeks after the initial injury.

Continue reading "Brain Injury Awareness and Concussions" »

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A study published in the August 29 issue of Science seeks to link Alzheimer’s with previous brain injury. Researchers at the Washington University School of Medicine in St. Louis and from the University of Milan took samples of fluid between the brain cells of 18 patients who were recovering from a traumatic brain injury or ruptured brain aneurysms. Changes in the amount of amyloid beta, a protein that is believed to play a key role in Alzheimer's disease, were thoroughly studied. “Proving that we can directly measure amyloid beta in the human brain is an important step forward for both clinical and basic research, and that may be true not just in Alzheimer's disease but also in other serious neurological disorders,” says co-first author David L. Brody, M.D., Ph.D., a Washington University neurologist. Levels of amyloid-beta in the brain increase as neuronal activity increases. The protein is known for causing plaques in the brains of people with Alzheimer’s disease. Previous studies using mice showed that amyloid-beta is a byproduct of brain cell activity. The studies with people show the areas of the brain that are most active are the most prone to developing Alzheimer’s plaques. This could be an important discovery that could help determine additional long-term side effects of suffering from a traumatic brain injury.

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The debate between a school district and the family of Mikey Berns is still in the works. An independent hearing officer listened to testimony from experts representing both the family and the school district. Mikey Berns, 5, suffered a traumatic brain injury when a cabinet fell on top of him last October. The parents have been fighting to get him full-time kindergarten schooling saying that their doctor and other experts agree that repetition helps with cognition and memory stability. According to their neuropsychologist, Dr. Bryan Hudson, the boy would benefit from attending both sessions and the school district is obligated to provide that service. “Any time you have material presented more than once, it increases the likelihood that it will be encoded and consolidated for later use,” Hudson said. Dr. Chris Sullivan, a neuropsychologist hired by the school district, reviewed the boy's medical records and told the hearing officer that the boy's memory is solidly average. The school district's attorney asked Sullivan if a longer day of instruction would help Mikey in which Sullivan replied, “"It is not the case more is better. It is how information is presented. Simply repeating curriculum is not necessarily going to produce gains you want,” Sullivan said. If Mikey and his parents win this debate, they want the school district to cover costs of the one-on-one special education he has been receiving.

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Ever since the military enacted cognitive testing before and after deployment of our soldiers, a number have been recognized as suffering a traumatic brain injury earlier. Still, it would be even more ideal if there was a technology that recognized the injury at the time it was incurred. The Brain Trauma Foundation, with the support of the Defense Department, is developing a handheld eye-tracking device that will enable military medical personnel to determine on the battlefield within seconds if a soldier has sustained a traumatic brain injury. Historically, TBI has been difficult to detect and was often under-diagnosed because the condition was confused with psychological rather than physical injury. Perhaps in the near future this technology will be available to first responders to emergencies and injuries stateside, such as EMTs, and will assist in the immediate detection allowing for treatment earlier. A rapid cooling technique, used in spinal cord injury, could be applied in route to emergency care for traumatic brain injuries. A number of innovative techniques, drugs and rehabilitation processes are being tested in clinical trials and some are close to FDA approval. The future is looking a little less bleak for families and for those who have suffered a TBI.

Posted by Kerry N. Jardine at 09:36 AM | Permalink | Comments (0) | TrackBacks (0)

An Indianapolis family is fighting for the right of their traumatic brain injured child to educational services mandated by law. Mikey Berns, 5, suffered a traumatic brain injury when a 150 pound cabinet fell on him last October. Mikey’s mother, Amy Berns, said the school district has refused to allow the boy to attend full day kindergarten at a local elementary school because they don’t believe he needs the services. Mikey’s doctor disagrees, saying it is vital to the boy’s education and development. His mother goes on to say, “That first six months and then that year mark is the most critical time frame in order to recoup those skills that were damaged from the injury.” Since the school refused to allow Mikey to attend full-day kindergarten, his family enrolled him in one-on-one instruction at a learning center at a cost of nearly $1,200 a week. His family is asking the school district to reimburse them for the private programs since law mandates care for special educational students and for the attorney costs mounting in their fight. “The government provides funding for special education children so that money is given to the schools so that they can implement an individualized education plan specific to that child's needs,” Berns said. “That's what they've failed to provide for him.” The school system countered, “Hamilton Southeastern provides a free and appropriate education to any of its students with special needs according to state and federal guidelines. This is an instance where the parents and school district disagree about what is appropriate,” Said a statement from Marianna Richards, director of school and community relations. This is just one example of discrimination against individuals with a traumatic brain injury.

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Paige Connard was in a cycling accident over Memorial Day weekend that left her with numerous injuries including a traumatic brain injury. She was wearing a helmet at the time, but the accident was severe enough that doctors had to remove a portion of her skull and right frontal lobe to alleviate pressure. Connard’s husband Gerry Jeffs was told by doctors that this was as bad as it gets. Before the accident Paige was a speech pathologist and the bitter irony is that she is to undergo speech therapy along with physical and occupational therapy. Her family says that they have yet to face the nightmare of insufficient medical insurance coverage that so often victims of TBI and their families go through. Currently, Connard is staying at CareMeridian in Gilroy, CA a facility that specializes in brain and spinal cord injuries. Those who have gone through the process of rehabilitation know how expensive it can get, with therapists known to charge about $100 an hour. According to Jeffs, their insurance coverage is good, but will not be enough to cover the therapy costs. Fortunately, Connard's friends and family have been there to support her both financially and emotionally, but many of the other thousands of Americans who have suffered a TBI are not so blessed. Some estimates of the total cost of TBI rehabilitation and recovery can be pegged at more than $1 million. It is important to know what recourse is available for victims of a TBI, so talk to a lawyer knowledgeable in the area.

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A traveling bathtub will be seen rolling down a mall in Minnesota to launch a campaign to prevent traumatic brain injury. We may ask what a bathtub has to do with TBI. The traveling bathtub scene is intended to bring attention to the number one cause of TBI which are falls. The Hennepin County Medical Center (HCMC) will have an interactive Brain Bar Kiosk that will include an educational display that will allow visitors to build their own brain and share it through an online gallery. Campaign workers will be recognized by their bathrobe and slipper apparel. Following the mall appearance, the Brain Bar will visit the Minnesota State Fair and the Minneapolis bike Tour. More than 1.5 million traumatic brain injury incidents are reported in the U.S. every year. Traumatic brain injury is the leading cause of death and disability among children and young adults.

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Sergeant Andrew Birzer had a military career spanning 17 years, but after experiencing a traumatic brain injury from a roadside bomb in Afghanistan he made the decision, “I'd rather be more sedated than more angry.” Birzer’s situation is not an unusual one. After the explosion four years ago, Birzer didn’t seek medical help and started another tour for thirteen months in Iraq. “I just ignored the headaches. The headaches, as far as I was concerned was stress from the situation,” he said. His family however, knew something was very different the moment he arrived home. Now his short term memory is poor and he takes dozens of medications for depression and anxiety. Sergeant Birzer’s situation speaks the same for thousands of non-military types who have suffered a traumatic brain injury. Thankfully, Birzer was finally diagnosed and now receives full time counseling and therapy to help with his life as a husband and father.

Posted by Kerry N. Jardine at 09:29 AM | Permalink | Comments (0) | TrackBacks (0)

The Department of Defense is in the process of distributing $300 million on research for traumatic brain injury and post-traumatic stress disorder. To put the amount in perspective, it is the most spent in one year on medical research since a $210 million breast cancer study in 1993. The distributions will fund 171 research projects. Gregory O’Shanick, national medical director for the Brain Injury Association of America, said the funding initiative is “without a doubt an all-time high” in spending by the government on traumatic brain injury and post-traumatic stress disorder. As is expected, civilian victims will benefit directly from the military studies. By contrast, the National Institutes of Health, the world’s largest government sponsor of medical research with an annual budget of $28 billion, spends about $80 million per year on TBI research, according to the NIH. “It is huge,” said Ross Bullock, director of neurotrauma at the University of Miami School of Medicine and lead investigator in a Pentagon-funded study of a drug designed to improve oxygen flow to damaged brain cells. “It is the just the most enormous thing that has happened in traumatic brain injury research.” According to Navy Capt. E. Melissa Kaime, head of the Congressionally Directed Medical Research Programs office the new research will focus considerable attention on TBI and studies are expected to complete between 18 months and 5 years. She further says that the military funding will go toward evaluating up to 20 different medications for TBI and studying ways of regenerating damaged brain cells. Half of the $300 million in Pentagon funds have been distributed, and all will be paid out by Sept. 30, Kaime said.

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With gas prices at an all time high more and more individuals are taking to the roads on their bicycles in order to save money, help the environment and maybe lose an extra pound or two. The Department of Health and Human Services and Making Headway Center for Brain Injury Recovery are taking this opportunity to remind those who elect to cycle their way about to be sure to wear a helmet. Wearing a helmet can prevent or limit the amount of head trauma experienced, thus evading the life changing effects of a traumatic brain injury. When about to purchase a helmet remember the following: check to be sure that the helmet is safe by making sure it dons stickers from the American National Standards Institute (ANSI), the Consumer Product Safety Commission (CPSC) or the Standards for Protective Headgear (SNELL). If it has one of these it has been deemed acceptable for cycling use. The helmet should also fit in such a way that it is level across the top of the head, should not move more than an inch in any direction and the straps should be adjusted so they are snug. If in a bike-related crash, replace the helmet because often the damage to the bicycle helmet cannot be seen and its level of safety has been compromised. Not all states require helmet usage in bicycling, but the obvious advantages to wearing one are apparent. While a TBI occurs every 21 seconds in the U.S., 85 percent of all TBI is preventable.

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In 2005 Tera Clark, 25, was hit by an impaired driver causing her a traumatic brain injury, broken neck, collapsed lung and broken bones. At first her progress was amazing, but when her recovery started to plateau, her mother decided to try Hyperbaric Oxygen Therapy. HOT is typically used in scuba diving accidents where the victims experience “the bends” because a too rapid ascent caused nitrogen bubbles to accumulate in the bloodstream. The therapy is sometimes used in hospitals to also help wounds heal, but this new treatment is considered “off-label” and experimental. The first privately-owned HOT facility in Arkansas has opened and this new clinic is using the therapy to treat traumatic brain injury. The treatment at The HBO Clinic in Little Rock is not covered by insurance because the clinic uses the oxygen therapy for non-FDA approved uses. For Tera Clark and her family it doesn’t matter because Tera has made significant progress. Her mother Jeana Halter said, “We are six weeks into the process now, and we've seen great improvements with memory, her cognitive skills, her ability to ambulate. Her joints have loosened up drastically. So I've been very pleased with it.” Dr. Gary Villines of The HBO Clinic said, “We can't promise that this will be of miraculous benefit, but there's enough evidence out there to show this is at least worth trying.” Dr. Villines hopes to have Tera walking unassisted within a year. Since he can treat patients in a private setting, and has less overhead than a hospital, he usually charges less than $200 per treatment.

Posted by Kerry N. Jardine at 11:09 AM | Permalink | Comments (0) | TrackBacks (0)

In an effort to determine the prevalence of chronic pain syndromes i.e. headaches in those with mild Traumatic Brain Injury and moderate to severe Traumatic Brain Injury, the Journal of the American Medical Association compiled data from searches executed in databases and articles published between 1951 and February 2008. The search found twenty-three studies including 4206 patients. In twelve of the studies involving civilians as opposed to veterans, they found 1670 patients of which 966 complained of chronic headache (57.8%). The prevalence of chronic pain was greater in patients with mild TBI compared to moderate or severe TBI. The report determined that chronic pain is a common complication in all ranges of TBI.

Posted by Kerry N. Jardine at 08:06 AM | Permalink | Comments (0) | TrackBacks (0)

Thanks to the men and women veterans of the Afghanistan and Iraqi wars, traumatic brain injury is gaining increased attention. Awareness has increased and so has the detection capabilities using new imaging and biomarker tests to diagnose TBI. Over the last decade researchers have increased their understanding of the physical effects of TBI and the technologies have improved to the point of helping communicate a clearer picture of the injury. In the past doctors would have to rely on an MRI or a CT scan, but those are not as adept at detecting neural damage associated with a TBI. Now there is diffusion tensor imaging, a type of MRI that could illuminate the individual axon pathways. Furthermore, tensor imaging has been found to be useful during recovery, showing doctors which parts of the brain were responding to rehabilitation. A chemical analysis, called a biomarker using proteins or enzymes, can show up in the blood with higher-than-normal or lower-than-normal amounts. Hospitals already use a biomarker test to diagnose heart attack victims and researchers are looking for a way to make diagnosing TBI as simple. There are a number of studies out there concentrating on the treatment of TBI including the neuroprotective abilities of the hormone progesterone and more currently cyclosporin, an immunosuppressant drug usually used in organ transplant patients. Both show promising results. Harvard researchers are currently conducting a clinical trial using citicoline, a type of stimulant that shows signs it might both protect and restore neurons. The Harvard team plans to publish preliminary results of the clinical trial soon.

Posted by Kerry N. Jardine at 08:21 PM | Permalink | Comments (0) | TrackBacks (0)

A grant from the National Institute on Disability and Rehabilitation Research has been awarded in the amount of $4.9 million to Carolinas Rehabilitation to study the drug Amantadine in the treatment of traumatic brain injury. The study will conduct research to determine if the drug, which is used to bring TBI victims out of a coma, can be used to limit the irritability and aggression often associated with a brain injury. Physicians from Carolinas Rehabilitation were the first to discover that Amantadine might extend its usefulness. The grant will be used to repeat the physicians’ findings at multiple sites nationwide to determine Amantadine’s efficacy in treating the cognitive dysfunctions often associated with TBIs. Carolinas Rehabilitation is a division of Carolinas HealthCare System of Charlotte, North Carolina which owns, leases or manages 23 hospitals in the Carolinas.

Posted by Kerry N. Jardine at 08:10 AM | Permalink | Comments (0) | TrackBacks (0)

NeuroHealing Pharmaceuticals is a company that develops products for individuals with traumatic brain injuries. The Food and Drug Administration recently awarded the company a three-year grant of $1,044,000 for the clinical development of NH001 from its Office of Orphan Products Development. The OOPD of the FDA is dedicated to promoting the development of products that demonstrate promise for the treatment of rare diseases or conditions. The NH001 product is currently in a phase IIa clinical trial attempting to improve the functional outcome of patients in a vegetative or minimally conscious state following a severe TBI. In the previous phase trials, the product has shown promising results and has received authorization from the FDA to begin an additional double blind Phase IIb clinical trial. Dr. Elkan Gamzu, acting Head of Clinical Trials at NeuroHealing, said, “This grant will provide the initial funding to begin the clinical program at the Spaulding Rehabilitation Hospital, a Harvard Medical School affiliated hospital and one of the leading rehabilitation facilities in the U.S., and will enable the continued development of this treatment which may offer patients, their families and physicians a new therapeutic option to help brain injured patients in an altered consciousness state.”

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Even with the increasing awareness of the worldwide epidemic of Traumatic Brain Injury, investors still are not interested in investing in companies that are developing therapies for TBI. According to Harry Tracy, who runs Cardiff, Calif.-based NI Research, a consulting and research firm focused on the neurological and psychiatric therapeutics industry, the amount of mid to large size firms developing drugs for brain injuries range from “zero to maybe 5 or 10 percent.” He further proclaims that “there are some promising programs that have really suffered” for lack of funding and investment. Most are small biotech or specialty pharma companies. While the current wartime as raised awareness of TBI, the condition has been “very much underappreciated from a drug development perspective,” according to Larry Glass, U.S. CEO of Neuren Pharmaceuticals Ltd. More than 1.5 million cases of TBI are reported annually in the U.S according to the Centers for Disease Control and Prevention and yet, “there have been virtually no big pharma efforts to develop drugs,” said Glass. While clinical development for TBI is complicated, uncertain and expensive, “the potential returns are phenomenal,” he concluded.

Posted by Kerry N. Jardine at 08:46 AM | Permalink | Comments (0) | TrackBacks (0)

Traumatic brain injuries due to falls are responsible for nearly 8,000 deaths and 56,000 hospitalizations in 2005 among Americans 65 and older, according to a new report from the Centers for Disease Control and Prevention. A study analyzed data from two agencies and provided a sampling of deaths and injuries in relationship to Traumatic Brain Injuries and the elderly. Death rates for fall-related TBIs were higher among men that women citing the numbers 26.9 per 100,000 for men and 17.8 per 100,000 for women. Traumatic brain injuries resulting in hospitalizations for both men and women were similar at 146.3 for men and 158.3 for women per 100,000. The rates of fall-related TBI deaths and hospitalizations increased with age. The median charge for TBI hospitalizations were $19,191 for men and $16,006 for women. With more baby boomers reaching retirement age, these types of injuries will increase and the demands on the health care system will be felt. In an effort to prevent as many as possible, the CDC developed tips and suggestions for older adults, their caregivers, health care providers and communities in a hope to communicate the dangers.

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Dr. Donald Stein and his colleagues authored a paper regarding the neuroprotective effects of progesterone administered to those who have suffered a Traumatic Brain Injury. Stein, director of Emory’s University School of Medicine Department of Emergency Medicine Brain Research Laboratory first discovered the neuroprotective properties of progesterone in the laboratory. Members of his research team have been studying its properties for nearly 20 years as well. They found that giving progesterone to patients soon after brain injury may reduce the risk of death and decrease the degree of potential disability. Laboratory studies found that progesterone is critical for the normal development of neurons in the brain and offers protective effects on damaged brain tissue. Progesterone is naturally present in the brains of both men and women. In the study published in the Annals of Emergency Medicine, Stein and his colleagues reported that only 13 percent of severe TBI patients who received progesterone died compared to 30 percent of those given a placebo. Furthermore, after 30 days 56 percent of patients’ functions had improved after a moderate TBI, including improved motor response and abilities to communicate. Few clinically effective therapies currently exist for TBI so the progesterone findings are welcome.

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Over the past 20 years science has been able to get a handle on the visual effects of traumatic brain injury through refined and improved neuroimaging techniques. Even though many believe “information is power”, the gap between knowledge and treatment is increasing. Tens of thousands of Americans lie in nursing homes in comas and other diminished states resulting from traumatic brain injury. Thousands more will join them each year. Unfortunately the majority are at the mercy of a medical establishment ill equipped to assess their needs and provide treatment, according to several recent studies. Although there are many potential treatments in trials and studies globally, a paltry few are used as an established treatment measure. In the last decade scientists have learned that the brain doesn’t stop growing and can repair itself in a process that is still barely understood. This is why, with good therapy, people can learn to speak, eat and walk again. “The brain isn't a black box anymore - we know a lot about what's going on now with head injuries in patients who are comatose for days or weeks,” said Dalton Dietrich, a neurologist and scientific director at The Miami Project to Cure Paralysis. “We're way past the dark ages of brain and spinal cord injury [of] 20 years ago.” Doctors hold on to the promise that every brain is as unique as its injury. Scientists at the University of Miami and elsewhere are looking for new breakthrough treatments such as: stem cell treatment, deep brain stimulators used in Parkinson’s, artificial blood and hypothermia to retard trauma. Funding remains a problem, but it is an epidemic whose numbers have exceeded those of HIV/AIDS and breast cancer.

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In a recent Psychiatric Times article, Dr. Ricardo E, Jorge professor of psychiatry at the University of Iowa, illuminated the impact of reintegrating Traumatic Brain Injury patients back into society. Consideration needs to be taken concerning their cognition and behavioral changes which constitutes the majority of TBI disabilities. In a control group of 939 TBI patients and 2,817 doctors a comparison was made between the effects of mental illnesses in those with moderate to severe and mild TBI. It was found that the prevalence of psychiatric illness in the first year following a moderate to severe TBI was 49 percent and those with a mild TBI experienced mental illness 34 percent of the time. What this means is that patients with moderate to severe TBI are 4 times more likely than the general population to develop a psychiatric illness in the six months following their injury. A discouraging 61 percent of those evaluated eight years after sustaining a TBI suffered from major depression and anxiety disorders, a significant amount more than those in the control group. Along with the increased number of mood disorders in TBI patients, researchers also found structural and/or functional alternations in the prefrontal cortex of the brain, indicating that structural brain damage plays a large part in psychiatric illness. Furthermore, not only does the TBI-caused damage to the prefrontal regions and limbic structures initiate mood disorders, but the disturbed neural circuits often continue to wreak havoc in the brain causing the illness to progress and evolve over time. As discouraging as this information is it helps create an increased awareness of the severity of this nationwide epidemic and will perhaps save a number of potential victims who instead chose to wear something as simple as a helmet.

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Earlier in the year Utah legislators approved House Bill 174 establishing a Traumatic Brain Injury Trust Fund. The trust fund begins with a one-time allocation of $50,000 intended to train medical personnel in treatment and recognition of traumatic brain injuries. The program will also help uninsured patients cover medical expenses not covered by Medicaid. “This fund could really open up the door for people who have been shut out of services in the past,” said Ron Roskos, director of the Brain Injury Association of Utah. “We hope this will be another avenue that individuals can use to access services.” More than 2,500 traumatic brain injuries occur a year and the number is increasing due to our returning war veterans. Only a handful of states have similar funds set aside for traumatic brain injuries. Once the distribution process has been finalized Rep. James Gowans – D, sponsor of the bill, will return to the legislature in the next session requesting long-term funding.

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Orange County California will be at the center of a new clinical trial using a hypertonic saline solution by emergency workers and medical doctors in the treatment and resuscitation method for victims of severe traumatic brain injury. The group labeled The Orange County Resuscitation Outcomes Consortium includes hospitals, healthcare agencies and fire departments. The ROC group’s effort will attempt to substantiate previous studies that have shown that hypertonic saline safely and effectively decreases inflammation in brain traumas. A similar approach was used with considerable success with the Buffalo Bill’s Tight End Kevin Everett after he suffered a spinal cord injury during a football game. The Orange County ROC trial will differ from other clinical trials because many of its participants will not be able to give consent or have family nearby to do so. Consent is required for all clinical studies, although federal law allows for exceptions if the safety of the product to be used has been proven in previous trials and if study leaders conduct community outreach discussions and opt-out measures for those who do not want to participate.

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Massachusetts tri-athlete Kenneth L. McDonnell, 58, was struck by a woman straying into the breakdown lane by her car while bicycling last fall, leaving him seriously injured. The woman was sentenced to one year probation, $350 in court fees and 100 hours of community service in a hospital or nursing home after her negligence caused a traumatic brain injury in the bicyclist. What makes this case interesting is that she must also complete the Brains at Risk program which is an “awareness and prevention court referral program that links dangerous driving behaviors to the devastating effects of traumatic brain injury,” according to the Brain Injury Association of Massachusetts’ website. McDonnell who is biking again was initially given a 1-in 4 chance of survival. He said doctors credit the fact that he was in good physical condition at the time of the accident which probably saved his life. McDonnell said he was wearing a helmet at the time, but it was smashed when he flew off his bike and onto the car. He said the brain injury has left him with short-term memory problems and personality changes. The court ruling is disappointing because he has little financial support while seeking a full-time position that allows for the uniqueness of his injury.

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Evidence found by clinician-scientists with the New York-Presbyterian Hospital/Weill Cornell Medical Center suggest that following a Traumatic Brain Injury patients should be given nutritional supplementation through a gastric feeding tube as soon as possible. They found it can improve the chances of survival by 4 times. “The evidence shows that the body heals better when it is given proper nutrition, not just the bare minimum that keeps someone alive,” says lead author Dr. Roger Hartl, a neurological surgeon at NY-P/Weill Cornell, and the Leonard and Fleur Harlan Clinical Scholar and assistant professor of neurological surgery at Weill Cornell Medical College. “Before now, patients were required to have nutritional supplementation within the first week following their injury, but our findings suggest that this is simply not soon enough.” The study's findings are published in this month's issue of the Journal of Neurosurgery. This is the largest study to ever look at the issue of nutrition and survival following TBI. The research team followed the survival outcome and nutritional care in 797 patients from 2000 - 2006. The study found that the best outcomes for patients with TBI were observed when theys received a minimum of 25kcal/kg each day. The study also found that as many as 62 percent of patients with TBI never experienced this level of caloric intake. Dr. Härtl said, “These new recommendations will be added to a widely used TBI handbook, 'Guidelines for Management of Severe Traumatic Brain Injury,'” published by the Brain Trauma Foundation.

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The Breckenridge Outdoor Education Center in Colorado is credited with encouraging and motivating many with disabilities including Traumatic Brain Injuries. Richard Abbott of Summit County, CO is one of them. Almost two years ago he was hit by a car while biking to work in Dillon in 2006. He was taken by a Flight-for-Life helicopter to St. Anthony’s Central Hospital in Denver, where doctors found he had sustained major brain injuries, numerous facial fractures and was launched into a coma they thought he would never emerge from. After several surgeries, he was transferred to Craig Hospital, a rehabilitation center outside of Denver which specializes in patients with spinal cord and brain injuries. He had to learn how to talk, walk and swallow all over again. He spent almost a year at Craig. Since 1976, the BOEC has been providing outdoor experiences for people with disabilities in the Rocky Mountains and beyond. “One of the biggest populations we work with is people with traumatic brain injuries, and in early June, we hold a brain-injury camp in conjunction with the Brain Injury Association of Colorado” said development director Marci Sloan. Abbott decided to take advantage of a seven-day brain-injury camp and arrived at the Scott Griffith Lodge in Breckenridge for a week of biking, rafting, fishing and rock-wall climbing. Although he still suffers from frequent bouts of dizziness that slow him down, he recently participated in the Third Annual Adaptive Cycle Fest at Keystone Resort, joining eight other riders on a scenic tour of Summit County’s bike paths.

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Poly-ethylene glycol (PEG) is being hailed as a possible new treatment used to minimize traumatic brain injury. The research is still in its initial phases. In the Journal of Biological Engineering a paper describes an experiment infusing rats suffering from a TBI with the self-described “spackle-like” substance within 2 to 6 hours of the injury. The PEG helped neurons by “sealing up” leaky membranes. The scientists found that the rats that were given intravenous PEG within 4 hours after brain injury had a better recovery than the rats who received a placebo. If further studies prove successful PEG could soon be carried in ambulances for immediate use in head trauma victims.

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A partnership has been developed between Force Protection Inc. and the Medical University of South Carolina in an attempt to create crash-test dummies with a faux brain that can be used to study the impact of trauma to the cerebrum. Earlier this month, Force Protection and MUSC announced the opening of their Force Protection Center for Brain Research at MUSC that is dedicated to traumatic brain injury. The center houses a Siemens 3-Tesla MRI scanner known for its extremely detailed images. Neurologist and psychiatrist Dr. Mark George will be heading the project and has focused on brain imaging most of his career. He says the problem with older scanners is that they cannot detect fine frays in the neuro-connections that make up the brain. “The problem with this type of brain injury is that it’s not easily detectable. People ask, ‘Are they faking it?’ And that sets up this terrible dialogue. The reason it goes undetected is that traumatic brain injury is a fraying of the cable and that is below the resolution of most scanners,” explained Dr. George. The project is still in its discovery phase and is exploring the best alternative for simulating the neuro-connections of the brain. It is the unfortunate plight of our soldiers returning from war that triggered this partnership, but the long term and far reaching significance will benefit all who have suffered from a traumatic brain injury.

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Utah agencies and community groups are uniting to increase visibility of traumatic brain injury services in that state. With the increasing number of veterans returning and being diagnosed with TBIs, the awareness of the injury has increased. Fortunately, Utah has a diverse network of services for people who have suffered a TBI, but many who qualify for care aren’t aware of what is available to them. The VA brought together federal and state agencies, community organizations and medical providers who work with TBI patients in a recent conference. According to Dr. Jennifer Romesser, a clinical psychologist with the Salt Lake City Veterans Affairs Health Care System, TBIs are so complicated and take a team of medical and social service providers to care for the wounded and their families. “Something that often comes up when working with patients and families is how difficult it is to know about the different resources available,” Romesser says. “And really what we were aiming to do with this conference was to try to educate providers about the difference services so they can help families and survivors navigate that really complex system of care.” It was fortunate that the VA called a conference and not only for the veterans. The group plans to publish a handbook of services all Utah residents can access who have been diagnosed with a TBI including our veterans.

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For the elderly, brain injuries have been found to be a little more than half responsible for their death according to a Centers for Disease Control and Prevention study. The CDC examined 16,000 deaths in 2005 that listed unintentional falls as the underlying cause of death. The elderly fear breaking a hip when they fall, but this new research proves otherwise. “A lot of people don't think a fall is serious unless they broke a bone, they don't think it's serious unless they break a hip. They don't worry about their head,” said Pat Flemming, a senior physical therapist and researcher at Vanderbilt University. Each year, one in three Americans age 65 and older fall. About 30 percent of them require medical treatment. Previous CDC research showed that the U.S. death rate from falling has risen a dramatic 55 percent for the elderly since the 1990s. The new study highlights the role that brain injuries play in such deaths. The consensus seems to be that as people age their veins and arteries are more prone to tearing during a sudden blow or jolt to the head according the CDC epidemiologist Marlena Wald. The tendency for tearing can cause a fatal brain bleed. Other factors include the use of blood thinners. To counteract the possibility of serious injury the CDC encourages older Americans to exercise to increase leg strength and balance. Glasses or a type of vision correction can help people avoid obstacles. Finally, the careful use of drugs that affect thinking and coordination, such as tranquilizers and sleeping pills should be carefully considered. “Falls are not an inevitable consequence of aging. These head injuries are not inevitable, either,” Wald said. The CDC research study is published in the June issue of the Journal of Safety Research.

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The Erickson family’s life in Missoula Montana changed forever the day their father and husband suffered a traumatic brain injury in a logging accident. Jeff Erickson in 2000, then 25-years-old, doesn’t know or remember what happened to him the day he was found unconscious in a tractor cab shortly after 10 a.m., let alone the previous six months of his life. Although loggers were downing trees near the accident, they heard nothing over the noise of chain saws as Jeff's 19,000-pound tractor tumbled 300 yards down the mountain. Once he reached the hospital the staff had to put Jeff in a drug-induced coma. Jeff remained in a coma for three weeks. Later he was moved to a community medical rehabilitation center and remained there for a little over a month. In rehab, Jeff's memory was hit-and-miss. He recognized wife and little girl. He couldn't recall his phone number, but he remembered his childhood number. He couldn't remember if he showered that morning, but when his wife and daughter brought in their miniature pinscher of 6 months and shouted “Scooby-Doo” just as always. According to traumaticbraininjury.net fifty percent of marriages fail within 24 months after a serious injury. His wife admits to staying with Jeff partly for the daughter’s sake, saying, “She needs her father.” Jeff still struggles with controlling his anger and relating with others, including his teenage daughter.

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A new documentary entitled “Wipe Out” directed by Lionel Goddard is a conglomeration of video footage of extreme sports activities and illustrates the epidemic of young men suffering permanent brain injury. Goddard says some of the most striking footage he obtained was from amateurs uploading to YouTube. He coined the findings as, “it was like shooting fish in a barrel. These kids doing all these extreme stunts on film had reams of footage of kids wiping out. It was terrifyingly easy to find.” In the film he grew close to three brain injured victims who are profiled, a professional snowboarder, skateboarder and motorcyclist. “It's by far the most intense film I've ever been involved with,” says the 40-year-old Goddard. “I can't think of anything tougher than talking on camera about a permanent brain injury.” He says there are some 30 traumatic brain injuries every day in British Columbia. “It's probably the biggest health issue that nobody is talking about.” Many victims are young men and teens, caught up in ever more challenging extreme sports. The dynamic has changed.

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In a study from the CDC released in the journal Wilderness and Environmental Medicine presented national outdoor recreational injury estimates and is believed to be the first type study of its kind. Between 2004 and 2005 there were approximately 213,000 people treated each year in emergency departments for outdoor recreational injuries. Of those injured, about 109,000 (51.5 percent) were young people between the ages of 10 and 24. For both men and women of all ages an overall, 6.5 percent of outdoor injuries treated were diagnosed as traumatic brain injury (TBI). “Participation in outdoor recreation is increasingly popular in the United States,” said Arlene Greenspan, Dr. PH and co-author of the study. “The good news is that there are ways to help stay safe while having healthy fun outdoors. For example, by wearing the appropriate helmet for snowboarding, snowmobiling, sledding and rock climbing, you can reduce your risk of having a head injury, which could become a traumatic brain injury. Helmets are one piece of equipment that can have a critical, positive impact.” She concluded.

Posted by Kerry N. Jardine at 08:24 AM | Permalink | Comments (0) | TrackBacks (0)

In a study from the CDC released in the journal Wilderness and Environmental Medicine presented national outdoor recreational injury estimates and is believed to be the first type study of its kind. Between 2004 and 2005 there were approximately 213,000 people treated each year in emergency departments for outdoor recreational injuries. Of those injured, about 109,000 (51.5 percent) were young people between the ages of 10 and 24. For both men and women of all ages an overall, 6.5 percent of outdoor injuries treated were diagnosed as traumatic brain injury (TBI). “Participation in outdoor recreation is increasingly popular in the United States,” said Arlene Greenspan, Dr. PH and co-author of the study. “The good news is that there are ways to help stay safe while having healthy fun outdoors. For example, by wearing the appropriate helmet for snowboarding, snowmobiling, sledding and rock climbing, you can reduce your risk of having a head injury, which could become a traumatic brain injury. Helmets are one piece of equipment that can have a critical, positive impact.” She concluded.

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In a landmark and hopefully precedent setting decision a class-action lawsuit has been settled in Massachusetts on behalf of 5 individuals with traumatic brain injuries, the Brain Injury Association of Massachusetts, and the Stayros Center for Independent Living. The settlement enables nearly 2000 victims of brain injuries to move out of nursing facilities and other institutions after the agreement. The complaint charged that the Commonwealth violated the Americans with Disabilities Act for failing to provide adequate community services. “This is a historic moment for persons with brain injuries in Massachusetts, many of whom have been unnecessarily institutionalized in nursing facilities, often for decades,” said Steven J. Schwartz of the Center for Public Representation, lead counsel for the plaintiffs. “As a result of the settlement, close to 2000 persons with brain injuries finally will be able to live in integrated settings, nearer to their families and their home communities.” Currently, approximately 8000 people with brain injuries reside in nursing and rehabilitative facilities in Massachusetts and according to the plaintiffs’ co-counsel at least a quarter of them could successfully transition to integrated community settings if those services were available. Arlene Korab, Executive Director of BIA-MA said, “Today’s agreement is a first in the nation for people with brain injuries and will serve as a model for other states.” The majority of people with brain injuries spend little time in hospitals and rehabilitative facilities. Once the initial treatment ends, these individuals are left to survive on their own because of the lack of community-based assistance with personal and rehabilitative care to return to semi-independent lives.

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The first ever rally/walk/run 5K in the nation will occur Saturday June 14, in Austin Texas. The fundraiser, The Peace of Mind 5K, is intended to salute and raise money for Americans with combat-related traumatic brain injuries. The event admirably occurs on Flag Day. One thousand American flags will be distributed to attendees to wave in support of those who have served our country. Proceeds from the Peace of Mind 5K will benefit the Defense/Veterans Brain Injury Centers, the Helping a Hero Organization, the Brain Injury Association of Texas and Easter Seals Central Texas. “As Americans, we should honor and serve those who have served our country and have made great sacrifices. These heroes deserve our full support in returning to society and leading full lives,” says Dr. R.W. Van Boven, an Austin neurologist who chairs the Peace of Mind 5K organizing committee. “The Peace of Mind 5K is designed to bring Texans together with one unified purpose -- a rally of support for American heroes who have been wounded at war.” Participants in the event include Texas Governor Rick Perry.

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When a traumatic brain injury has occurred the damaged nerve cells are unable to regenerate. If the injury is severe enough cognitive functionalities can be permanently lost. Patients may experience difficulties in memory and attention, language skills, emotional control, behavior and sensations. The CDC estimates about 5.3 million Americans who have had a TBI need some measure of help with routine daily activities. Post TBI patients may have permanent brain damage, yet the unaffected areas of the brain can be trained to replace some of the injured brain’s lost functions. Valid and useful rehabilitation is imperative for patients with TBI. The goal of rehabilitation is to help patients regain their independence potential. Each patient has different needs and abilities so rehab programs need to be personally tailored to each individual. As an example of critical care for patients with TBI, Scripps Memorial Hospital has developed an intensive outpatient rehabilitation program. TBI patients participate in six-and-half hour program three to four days a week. The program uses a team of psychiatrists, psychologists, nurses, speech therapists, occupational therapists, physical therapists and social workers in conjunction with family who work regularly to develop and personalize rehabilitation programs for each patient. The program also helps families find local resources to assist and support patients as they move back into semi-independent living. The cost of traumatic brain injury treatment and rehabilitation can reach into the millions of dollars, that is why it is imperative to know what can be done to help finance such an endeavor and what rights the individual and family may have.

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In a case of municipal negligence a 14-year-old boy was struck by a car while riding a bicycle and sustained a traumatic brain injury. His father sued the city of Hanford, California on behalf of his son claiming poor roadway maintenance and lack of appropriate signage led to the life-changing injury. The week before trial, the city of Hanford settled out of court for a lifetime stream of payments of equaling $15 million. According to the lawsuit, the intersection where the accident happened was hazardous to school children crossing the road. Hanford’s records showed the city was aware of the deficiencies of the intersection but did not correct them. The settlement will cover the boy’s past and future medical expenses, therapy and 24 hour care for the rest of his life.

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Hyperbaric oxygen therapy (HBOT) is known for its treatment in medical conditions caused by scuba diving such as decompression sickness, or ‘the bends’. HBOT is a system where a patient in a pressurized chamber breathes 100 percent oxygen. Normally, we breathe 20 percent oxygen and 80 percent nitrogen. According to the United States National Library of Medicine and the National Institutes of Health, the air pressure inside a hyperbaric oxygen therapy chamber is two and a half times greater than normal atmospheric pressure. “Oxygen is dissolved into the lungs and into the liquid portion of the blood,” said Paul G. Harch, M.D., a hyperbaric and emergency medicine physician. “It reaches areas in the body it normally wouldn't reach because of the very high concentration.” Now, there are many other medical conditions benefiting from HBOT therapy. HBOT has been found to be an effective system in increasing oxygen delivery to the brain. The therapy is not only effective in treating traumatic brain injury, but in strokes, cerebral palsy, autism, near drowning, near hanging, birth injury, genetic disorders like mitochondrial disease, multiple sclerosis, chronic fatigue, among other conditions.

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Mount Sinai School of Medicine researchers have found a link between traumatic brain injury and social and mental dysfunction. Their conclusion sounds intuitively obvious, but what is surprising is the apparent mild nature of the injury. A long forgotten mild traumatic brain injury could be linked to literacy problems and drops in intellectual abilities and eventually addiction problems. Wayne A. Gordon, director of the Brain Injury Research Center at the Mount Sinai School of Medicine, explains, "Unidentified traumatic brain injury is an unrecognized major source of social and vocational failure.” Ongoing complications experienced by traumatic brain injury victims include seizures, infections, nerve damage, cognitive disabilities, sensory problems, difficulty swallowing, language difficulties, personality changes and Alzheimer's or Parkinson's disease

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Craig Sears suffered a traumatic brain injury more than 20 years ago. The system was ill-prepared to help him. Unfortunately, after he learned how to walk and talk again was when things became tougher. He couldn’t work and no insurance company would cover him. He turned to life on the streets and began using drugs and alcohol to dull his pain. He eventually was arrested and sent to prison for five years. Again, the system was not set up for traumatic brain injury survivors and he was incarcerated with murderers and rapists. After his release he was determined to improve the system for people with TBI and became part of a lawsuit in the early 1990s for people who had been incarcerated with a TBI. Sears also became involved with Goodwill and eventually began a support group where people could share their stories and help others in similar situations. He wanted to make a difference by raising awareness about the plight of TBI victims. Medicaid and Goodwill along with matching funds from state and federal governments is now helping victims of TBI live independently instead of in a facility and living more normal lives.

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The International Brain Injury Association held their Seventh World Congress on Brain Injury in Lisbon, Portugal April 9 through 12, 2008. The IBIA World Congress is the largest international gathering of brain injury professionals. Delegates are comprised of Neuroscientists, Physicians, Psychologists, Neuropsychologists, Therapists, Social Services professionals, Nursing professionals, Case Managers, Lawyers, Policy Makers, Advocates, and others working in the field of brain injury. The five day conference brought together over 700 world renowned experts in the treatment of traumatic brain injury in an effort to enlighten the scientific and medical professions on new and successful treatments and techniques. IBIA endeavors to bring together the best professionals in the area of brain injury to collaborate and share their work among peers.

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Bob Lane’s vehicle was hit on a highway and rolled up to six times, but doesn’t remember any of it. About a year later he and his wife noticed he was having difficulty remembering simple things as well as keeping his balance, often falling over without realizing it. “One day, I was writing stuff down and when I read it again, it didn’t make any sense,” Lane said. “I knew what I was writing while I was writing it, but if I read it later it was just a jumble of words.” The symptoms he suffered were easily overlooked and thought to just be a sign of old age. The damage to Lane’s brain is not detectable by an MRI or other brain scanning techniques because the damage is to the brain’s electrical and nervous systems. During one of his hospital visits, he met Dr. Marianne Talbot, founder of the National Rehabilitation and Rediscovery Foundation in Falls Church , Virginia, and learned about The Hope Project, a series of classes and workshops for people living with traumatic brain injury. The Hope Project consists of four, two-hour class sessions each week. Students of all ages and ability levels meet to discuss their difficulties and their goals for living more independent lives.

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Jacob Delva was in a car accident that when the ambulance crew arrived they expected no survivors. He was heading to school on March 2, 2004, on a fog shrouded highway. “On my way to school, I hit a tree when I was trying to pass a car, and I seen headlights. I went off to the ditch because I thought, 'I don't want to hurt anybody else or kill anybody else's mom or dad because of my stupid driving,'" Delva said during a break at Fresh Start, a service that helps people with brain injury work on long-term therapy goals. After coming out of a coma he spent a year in a half in a rehabilitation unit at the Mayo Clinic. The demanding work of rehabilitation was long and difficult. He had to learn everything all over again including how to talk. “The first thing I learned was this,” Jacob said, extending his arm on a table, curling his index finger and moving it back and forth. “I had to sit and do this all day.” He had to practice that simple task about a week before adding his entire arm to the exercise. Now, the tremors in his hands, his unsteady stride and the way the brain injury affects his speech are often misunderstood. Jacob’s recovery has been riddled with misunderstanding and judgment. Recently, authorities were called when Jacob became agitated because of his frustration with his progress in therapy. They believed he was drunk and disorderly and used a Tazer on him in an effort to control him. He fell and struck his head on the ground, risking a new brain injury. This is not the first such incident but Jacob and his mom want to encourage those who have suffered severe traumatic brain injuries that continual improvements happen and not to give up hope.

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In August 2005, Brigadier General Patt Maney was patrolling Afghanistan when a road side bomb exploded in front of him. He survived the explosion, but suffered a Traumatic Brain Injury. “I was having trouble articulating, finding words and articulating thoughts and symptoms even," Maney said. "I knew I couldn't do things that used to be simple.” Although there is no cure for TBI, researchers at Louisiana State University have found a treatment used in scuba diving accidents as a possible solution. After none of the usual standard treatment helped Maney, he agreed to try the experimental option LSU suggested, Hyperbaric Oxygen Therapy. After 80 treatments of breathing pressurized pure oxygen in a hyperbaric chamber he saw dramatic improvements. “It has improved my cognition, my word finding, my balance,” Maney said. “I had tremendous balance problems, I'd just fall over.” Paul Harch, M.D., a clinical assistant professor at LSU School of Medicine, has studied the effects of hyperbaric oxygen therapy on more than 500 patients including those with neurological conditions such as Parkinson’s. He found that over time high does of oxygen stimulated the brain to repair itself. “What we see is a general improvement in the majority of those functions, a return to pre-injury status. It turns their lives around,” Harch said. Brigadier General Patt Maney now works as a judge in Florida. He said he hopes hyperbaric oxygen therapy can be used to treat some of the nearly 400,000 soldiers coming back from Iraq and Afghanistan with brain injuries. Unfortunately, since the hyperbaric oxygen therapy is considered experimental, the $200 per treatment cost is typically not covered by insurance.

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When it comes to traumatic brain injury in civilian life, prevention is the best solution. In this month of proms, two drivers who acquired a traumatic brain injury while driving drunk wanted to communicate this essential truth to teens. Alcohol related crashes are the major cause of traumatic brain injuries. “I hit the wall and broke the windshield on my head. I was in an instant coma for six months. My blood alcohol level was .03. I was legally drunk,” said KJ Haddad, a traumatic brain injury survivor. “I remember when they had to cut the roof off my car to get me out,” said Matt Rivet, another traumatic brain injury survivor. These two real life examples were both young and had their whole lives ahead of them. Rivet was in his 20s and Haddad was 17. Haddad has not opened his hand since 1986 and his left leg is almost useless. These two are among 5 million Americans living with a traumatic brain injury. “Traumatic brain injury is the leading cause of death among adolescents,” said Dr. Karen Bougas, of New England Rehab Hospital. “Fifty percent of the traumatic brain injuries are alcohol related.” As Rivet and Haddad continue to recover at New England Rehab Hospital years after their crashes, they are dedicated to telling their stories in hopes of save lives.

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Neurogenesis therapy for Stroke victims has been used since the nineteen nineties and has shown considerable promise for those with a traumatic brain injury. University of Alabama neuroscientists are proving the myth that adults cannot grow new brain cells, false. It is called Constraint Induced (CI) movement therapy and it has been shown to significantly increase the amount of “grey matter” in the brain. The therapy includes restraining the patient’s unaffected limb and making them use the affected one. Using CI therapy seems to “increase the amount of blood vessels in the brain or the number of synaptic connections established between neurons,” says Edward Taub, a lead researcher in the area. The grey matter increase may also be attributed to the brain creating new neurons. CI therapy has demonstrated an effective machination for helping patients to recover and many others have observed significant clinical improvements globally, such as recovering the functionality of paralyzed limbs. This therapy has confirmed neuroscientists’ belief that the brain can remodel itself.

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Another study from a research team consisting of members from Hangzhou Normal University and Zhejiang University in Hangzhou in China has found the neuroprotective effects of using progesterone to treat Traumatic Brain Injury. The study was published in BioMed Central’s open access journal Critical Care. The Chinese researchers studied 159 patients with acute TBI in a random and double-blind trial where approximately half the patients received progesterone and the other half a placebo for five day after the injury. “Although previous studies in animal suggest that progesterone may mitigate the severity of brain damage, there is no information about therapeutic benefit of post-TBI progesterone injections in the patients with severe brain trauma” said supervising professor Weiqi Yan. “Our work was to determine if progesterone improve chances for recovery in patients with severe injuries in a longer-term”. At three and six month evaluations after treatment, significantly more patients given progesterone had favorable outcomes compared to patients given a placebo. The researchers also found that progesterone treatments were also linked to the increase in survival at six months. Additionally, no adverse events or complications were experienced by the patients given the hormone. “We found encouraging evidence that progesterone may significantly improve 6-month neurologic outcome of the patients who were enrolled with acute severe TBI” according to lead author, Dr Giomin Xiao. “Our results provide information important for further multicenter clinical trials on progesterone as a promising neuroprotective drug”.

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A once active and successful student and athlete is undergoing mental calisthenics to help with the symptoms of a Traumatic Brain Injury she incurred. Seven years ago Sarah Kmet was practicing softball when she was struck in the head. She was taken to a clinic, but it wasn’t until later that her mother noticed a difference in her daughter’s behavior. Doctors later diagnosed her with a TBI. As part of her rehabilitation, twice a week she undergoes Interactive Metronome Therapy. It is a computer program that uses sound and rhythm to strengthen motor control, increase patient’s memory and the ability to multitask. Sarah Kmet has been using the program for more than a year. One of the purposes of the program is to help TBI victims self regulate by monitoring their actions in the hope of controlling their cognitive and emotional behavior in the real world.

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Awareness of a little known side effect of Traumatic Brain Injury is growing thanks to the efforts of the director of low vision optometry at West Haven Veterans hospital, Dr. Kara Gagnon. Gagnon has spent the last four years trying to educate those in the medical profession of the implications of a TBI and resultant vision issues. Studies have shown that in the general population, about a third of people with acquired brain injuries have associated neurological vision impairment. Gagnon began to connect the vision consequences as soon as the war started. Double vision, trouble focusing and poor spatial orientation are among the side effects of a TBI. Last winter, Gagnon helped bring together military and Department of Veteran Affairs clinicians for a national summit on the issue. Her drive began as a result of professional and personal reasons. In 12 years at the VA, she had seen many aging veterans at her clinic confide they'd been unable to read or focus for decades because their visual impairments went unattended, she said. At the same time her own 8-year-old son was having learning problems that she was able to trace back to a head injury from three years earlier when he fell off a bike. Gagnon said the conference accomplished its objective of bringing together vision specialists with poly-trauma professionals to collaborate on the screening and treatment of TBI.

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In an article published in the online journal Brain a report was made on a study of brain injured Vietnam War Veterans and cognitive decline (as opposed to dementia) many years following a head injury. Evidence was found that patients with a penetrating head injury (PHI) demonstrated considerable cognitive deterioration. These findings are significant because traumatic brain injury is the primary cause in the U.S. of death and disability in those under 35 years of age and the numbers do not currently include the nation’s soldiers. The cognitive, behavioral and social deficits caused by TBI exacerbate the dilemma. This information demonstrates that TBI is a long term problem with little solution.

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Sports agent Leigh Steinberg describes traumatic brain injury as "an undiagnosed health epidemic" and "a ticking time bomb." According to the Brain Injury Association of America, football is responsible for approximately 250,000 head injuries each year. The National Football Leagues estimates there are about 100 concussions per season. A player may suffer a concussion that could manifest itself later in life in the form of depression, early-onset Alzheimer’s disease or dementia. Jason Demery, a University of Florida clinical assistant professor in clinical and health psychology says the majority of those who sustain a single Mild TBI go on to recover spontaneously, but there are still 10 to 15 percent who still have persistent, post-concussive symptoms a year after their injury. He goes on to say that the incidence of depression and emotional complications can be one of the aspects of a traumatic brain injury. “The research shows the incidence can be as high as 70 or 80 percent after a single concussive episode,” he said.

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New Mexico doctors and lawyers faced off against each other on a court, but it is not in litigation, it’s on a basketball court to raise money and awareness for Traumatic Brain Injury. The Friends Helping Friends support group hosted its 22nd annual charity Doctors vs. Lawyers basketball game April 24th. In this court battle everyone wins. The game raised enough money last year to send people to a state conference to educate them about traumatic brain injury, what resources are available and the latest research and treatment. One of the support group’s participants is Heather Hales, she is married to Tyson who sustained a traumatic brain injury in 2000 while working in an underground coal mine in Utah. Tyson spent three months in a medically induced coma and once he awoke he spent an additional two years of rehabilitation. “I feel the effects of the injury every day,” he said. “I always have to write down everything because I have no short-term memory. I listen. My hearing is fine. I pay attention, but I just can't remember things.”

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At the second National Sports Concussion Summit it was announced that thankfully to the increased awareness and the recognition and consequences of head injuries in athletics, concussion denial is decreasing. “It's taken a long time to get there, but right now I think the public awareness is huge,” Dr. Robert Cantu of the Neurologic Sports Injury Center at Boston's Brigham and Women's hospital. “It's as if the Berlin Wall of concussion denial has fallen,” said sports agent Leigh Steinberg, noting a significant shift in both attitude and action within sports since the first summit was held a year ago. Steinberg, who helped organize the summit along with the Sports Concussion Institute, is sponsoring a California program that will institute “baseline testing” in 1,400 high schools, where athletes are given a cognitive exam that can be repeated after injuries to measure brain impairment. Other states like Hawaii have introduced such testing as well. Similar neurological tests were made mandatory last year in the NFL. Sports agent Leigh Steinberg is well known for representing clients whose professional career ended after a number of concussions. He described a moment in 1993 when he saw Troy Aikman after the Dallas Cowboys defeated the San Francisco 49er in the NFC title game. “He asked me where he was,” Steinberg said. “He asked me if he'd played that day. He asked me if he'd won. I said, 'Yes, you're going to the Super Bowl.' Ten minutes later he asked me where he was again.” Steinberg said he knew at that point he had to work on maintaining the minds as well as the money of his clients and other athletes. “It terrified me,” he said.

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The University of Alabama at Birmingham has developed a rehabilitation therapy for those with brain injuries caused by stroke. Constraint Induced (CI) therapy produced significant increases in the amount of gray matter created in patients receiving the therapy. “This changes all of our perspectives about what is possible in the brain,” said UAB neuroscientist Edward Taub, Ph.D., a study author and the developer of CI therapy. “For years, science thought the adult brain was hardwired, with no ability to change or adapt. Now we have further proof of the concept of neuroplasticity, the brain’s remarkable ability to respond to damage to compensate for the injury.” Constraint-induced therapy (CI) forces the use of the affected side by restraining the unaffected side intensively for two weeks. Other researchers worldwide have documented the same success. The changes observed worldwide were dramatic improvements in use of brain injured affected arms or legs and increased blood flow and stimulation of brain cells. Dr. Taub also reported noticeable and promising changes for those with blunt force trauma to the brain resulting in a traumatic brain injury. “We’ve shown that CI therapy can harness the plasticity of the brain for therapeutic effect in conditions with few practical treatment options,” Taub said. Exactly what causes the increase in gray matter thus the increase in physical and functional success still remains elusive. Taub speculates there are several possibilities. It may be due to an increase in the amount of blood vessels in the brain, or in the number of synaptic connections established between neurons, an increase in the amount of glial cells, or the intriguing possibility that the brain is creating more neurons. “The idea that the brain can make new neurons in adulthood…neurogenesis…has only been accepted by the scientific community in the past several years,” said Gitendra Uswatte, Ph.D., associate professor of psychology and study co-author. “These findings open the door to the possibility that the brain can indeed recover from traumatic injury by creating new brain cells to replace those lost by injury.”

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Dr. Samuel Weiss, Director of the Hotchkiss Brain Institute at the University of Calgary, received the distinguished Gairdner Award for his work in finding nerve cell regeneration in adult neural stem cells. Dr. Weiss found that the adult brain can produce new adult stems cells that can grow into new brain cells called neurons. The stem cell regenerative work is Stem Cell Therapeutics Corp.’s therapeutic approach to traumatic brain injury, stroke and multiple sclerosis. Dr. Weiss’ study uses a therapeutic regimen of two approved and clinically well known drugs, human Chorionic Gonadotropin (hCG) and Erythropoietin (EPO) that stimulates the growth of new neurons to replace the brain cells that were lost or damaged. Animal studies showed a significant recovery of motor function when the regimen was applied 24-48 hours post stroke injury.

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In Sioux City, Opportunities Unlimited, a treatment and support center for those suffering the affects of a Traumatic Brain Injury could provide additional resources and assistance if President Bush signs a bill passed by the Senate 324-1. It could help the group treat its patients more effectively. The attendees all have a story of injury to rehabilitation and the day to day struggles they still experience. Stephanie Reinsch from the center says, “They were living full productive wonderful lives with their families working in the community doing the things we take for granted everyday.” She says the Act on President Bush's desk will increase research and funding for Traumatic Brain Injuries and is a great step for attendees at Opportunities Unlimited. Reinsch continues, “So any increase in awareness any increase in funding is going to be helpful to everyone whether they're a civilian or a military men or women.” Through raising awareness it may increase treatment options for TBI suffers at the center. Treatment of mild to moderate TBIs is thought to cost up to $2 million in the first year alone.

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A construction accident that left a man with a serious head injury had a piece of his skull placed in his abdomen until the swelling in his brain went down. Jairo Rodriguez was working in a basement for a construction business that was uninsured at the time of his injury. A piece of brick wall fell on him pinning him against another brick wall causing him to hit his head and lose consciousness. “They had to keep that part of the skull (or bone material) alive,” said his wife, Jessie Rodriguez. “He had suffered a blood clot to his brain and there was so much blood and swelling, he had a drainage tube from inside his brain.” The doctors are ready to remove the piece of bone from his abdomen and reattach it to the rest of his skull. The couple has already amassed $25,000 in hospital bills before the surgery and the surgery will cost an additional $10,000. Jairo has regained the ability to walk and talk, but the far-reaching implications of his injury will cause many financial and emotional difficulties for him, his wife and their 2 year and 3 month old sons.

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Utah Senator Orrin Hatch introduced a bill more than 10 years ago to improve the screening and treatment options for Utah residents suffering from traumatic brain injuries. The bill that funds treatment and outreach programs for TBI victims is up for reauthorization in the state’s senate. Brain Injury Association of Utah executive director Ron Roskos said, “This traumatic brain injury act opened a lot of doors that may have been closed prior to that. We look at the acquired brain injury waiver, the traumatic brain injury fund that just passed the grant that the state of Utah received through the traumatic brain injury grant, and then the ongoing research and information we receive through the Centers for Disease Control. Those are phenomenal things.” The Traumatic Brain Injury Act Reauthorization has passed through the Senate and House, where it was amended. It now heads back to the Senate for approval. Meanwhile, Utah's Legislature approved a TBI fund this year to help disabled Utah residents access treatment. The CDC reports that in Utah alone there are 44,000 Utah men and women living with the disabilities associated with traumatic brain injuries.

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Anne Forrest was an economist with the Environmental Law Institute, a think-tank devoted to protecting the environment, when 12 years ago she was rear-ended and sustained a mild traumatic brain injury. Now, she’s hoping that she has recovered enough to be able to drive again in May. She told medical professionals gathered at a presentation on mild traumatic brain injury about the hurdles she’s experienced in the physical, emotional and financial obstacles. The presentation was organized by a rehabilitation center specializing in brain injury, to raise awareness about the injury and the struggles TBI victims face. During her presentation she expressed how the injury left her enervated stealing her ability to work long hours. She lost her balance and her short-term memory while limiting her speaking abilities and causing frequent headaches. Her primary care physician and insurance provider expected her symptoms to disappear within two years. When she didn’t improve she was accused of malingering, a condition psychologists define as the intentional exaggeration of physical or psychological symptoms. As the years progressed she received speech and language therapy and was assisted in re-learning life lessons and found the proper tools for managing her daily life with the assistance of a brain injury treatment center. Anne Forrest’s experience highlights one of the most troubling issues for TBI patients, the lack of knowledge in the insurance industry, medical profession and the public.

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New technology currently being used for patients who suffered a brain bleed could have positive applications for those suffering from a traumatic brain injury. It is the NESS L300 neuroprosthesis. Those who suffer a brain injury often experience “toe drag” that makes it physically difficult to balance and walk. NESS stands for Neuromuscular Electrical Stimulation System. The device is strapped just below the knee with a sensor located in a shoe sends a wireless signal during a step that causes an electrical stimulation in the brain causing the toes to lift. The L300 rebuilds the connection between muscles and the brain and once the brain retrains itself the device is no longer needed. “Although patients can continue to use the device if they need to, in most patients the therapy retrains the brain,” said Jean Gaylord a Rehabilitation Admissions coordinator. “Parts of the brain near the damaged part learn to take over the functions. The L300 can be used to treat a number of conditions including stroke, traumatic brain injury, multiple sclerosis, cerebral palsy and incomplete spinal cord injury." She also said Medicare and some private insurance companies cover the use of the NESS devices.

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California state Senator Joe Simitian in his “Oughta Be A Law” contest has awarded Jerome Blum this year’s winner. Blum never fought in combat, but as a military doctor 50 years ago he saw first hand the effects of combat on others. Once Blum learned that thousands of troops returning from Iraq and Afghanistan were suffering from undiagnosed traumatic brain injuries he decided he wanted to do something about it. He approached Sen. Simitian and proposed the bill SB1401 that would require the state Department of Veterans Affairs and the California National Guard to provide information to vets about brain injuries and the care that’s available to them through the U.S. Veterans Administration. Typically care is provided by the federal government, not state. The military is required to check for these types of brain injuries, but often no immediate symptoms present themselves in the veterans. However, once they return home and try to adapt to their civilian life they experience memory loss, personality changes and a host of other problems. Blum’s empathy for the veterans turned into action. When he retired a few years ago, he decided that he would do what he could to help the Gulf War veterans so that the tragedies the Vietnam veterans experienced would not be repeated. Blum was invited to Sacramento to testify before the Senate Veterans Affairs Committee about the cost to the state, human and monetary, of failing to screen veterans. “If we do not diagnose these men and women and treat them, they will become substance abusers,” he told the committee. “They will beat up their husbands and wives. They will end up in prison, which costs $52,000 a year. Forget about morality, just look at the bucks.” If the bill passes, California will be one of the first states to provide such services to its veterans. The bill was unanimously supported and will now go to the Appropriations Committee.

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An organization known as Mothers Against Brain Injuries is trying to make the hospital experience for the family a little more comfortable. The group offers “Totes of Comfort and Hope” that contain personal comfort items, hygiene products and brain injury literature in large canvas bags. The bags are given to the family member of a traumatic brain injury victim with 48 hours of their hospital arrival. Tracy East-Porter is the brainchild of the organization. Her teenage son suffered a serious traumatic brain injury in a car accident. Currently the project is limited to 21 Florida hospitals, but the service is of such value that perhaps future growth will occur.

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The brain trauma bill S. 793 passed with a 392-1 vote by the U. S. House of Representatives in Washington D.C. The bill is intended to expand research into and surveillance of traumatic brain injuries across the U.S. The new legislation is intended to authorize the National Institutes of Health and the Centers for Disease control and Prevention to conduct a study into traumatic brain injury trends across the nation and identify possible treatments. It is also intended to fund state projects to improve access to rehabilitation. National brain injury costs are estimated at $60 billion a year or more. The Senate is expected to send it to President Bush for his signature soon.

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Following on the heals of a successful traumatic brain injury phase II-a trial and Food and Drug Administration’s acceptance of the results, Synthetic Blood International, Inc. will file its intentions with the FDA for a phase II-b clinical trial in the use of its product Oxycyte for TBI within days. The company plans to include a multi-center, double-blind and placebo controlled study enrolling up to 300 patients. A major portion of the study was made possible by a Department of Defense $1.9 million grant. Oxycyte is a perfluorocarbon (PFC) therapeutic oxygen carrier and blood substitute.

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Early evidence from new research out of Dublin has shown that patients with traumatic brain injuries who were treated with an Alzheiher’s drug over a year showed improvements in memory and attention. Currently, individuals presenting with dementia are prescribed Donepezil, sold under the name Aricept. Purportedly it increases levels of a brain chemical linked to memory. Aricept suppresses a natural enzyme which normally breaks down acetylcholine, a brain chemical that allows neurons to pass messages to each other. The study came about in discussions between Alzheimer’s doctors and those treating traumatic brain injury patients at a rehabilitation hospital. Dr. Simone Carter, who led the research, began a pilot study of nine patients and found that a daily dose of Aricept improved memory, concentration and attention while also appearing to reduce fatique. Dr. Simone still believes a larger clinical trail involving 200 or more patients is still needed to prove the efficacy of application of Aricept.

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Channel 7 news in Denver reported on a clinical trial testing a new handheld device called the NeuroThera in victims of brain injuries, including those who suffered stroke. The device delivers high-intensity infrared energy via a laser to a patient's head to stimulate inactive mitochondria in brain cells to prevent or slow further cell death. Mitochondria are a protein that serves as a power supply to cells. The clinical trial is hoping to prove that once the injured and energy starved brain cells are empowered by the mitochondria, they should be able to resume function. In stroke patients the NeuroThera works by keeping surrounding brain tissue alive while supply of blood, oxygen and other nutrients are blocked. The clinical trial is sponsored by the developer PhotoThera and is being tested at the University of North Carolina, Duke University Medical Center and three other North Carolina hospitals. An earlier study of the device was used on stroke patients of whom 70 percent treated with NeuroThera within 24 hours improved compared to 51 percent who were not treated with the device. Researchers in North Carolina are hoping to enroll 660 patients to test NeuroThera in the near future. The availability of a handheld and transportable device to treat traumatic brain injury is attractive with a myriad of applications.

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In June 2004 Minnesota boy, Keaton Bowden was riding his bicycle without a helmet and was hit by a pickup truck. “He woke up from the coma and we got a whole new son. Whole new personality. Different issues from any other typical now 15-year-old,” said Jay Bowden, Keaton's father. Once an all-star athlete, Keaton suffered a traumatic brain injury and now struggles to focus on a video game for more than five minutes. His emotions can change in lightning speed from smiling and agreeable to explosive rage without provocation. Contrary to doctors’ expectations he is walking again, but the frustrations and battles are neve rending for Keaton and his family. “He's in history right now and he gets all the facts confused sometimes. Last year he was in history and he thought the FBI was following him when they were talking about Watergate,” recalled Amanda Bowden, Keaton's mother. Ardis Sandstrom, the executive director of the Brain Injury Association of Minnesota cited troubling facts, “We see 75 percent of marriages fail after brain injury. We see families just fall apart.” Sandstrom said more than 10,000 Minnesotans go to hospitals each year for head trauma, and too often they go home not knowing they've suffered a brain injury. “So I want parents to think about when your child is suddenly acting out, go back and think were they in any kind of an accident that they may have hit their head because they usually get misdiagnosed,” she said. Every injury is different, but Keaton's brought all the classic problems including trouble concentrating and problem solving, and loss of memory and coordination. Prevention of traumatic brain injuries includes helmets for any risky sports and seatbelts and car seats for anyone in a vehicle. Keaton laments, “Please wear a helmet. If not your life is going to change forever, like mine did.”

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In a possible breakthrough for neurological research the identification of a new marker is making it possible to track brain stem cells for the first time. In explaining the discovery of tracking stem cells in the brain Dr. Mirjana Maletic-Savatic, assistant professor of neurology at the State University of New York says, “This is a way to detect these cells in the brain, so that you can track them in certain conditions where we suspect that these cells play a certain role. This is also very applicable for situations where people envision the transplantation of stem cells into the brain,” Alzheimer's, Parkinson's, multiple sclerosis, traumatic brain injury or stroke, cause debilitating injury to the human nervous system and/or brain. However, because stem cells have the potential to develop into other types of cells, scientists believe they might be manipulated to repair or replace lost cells and tissues. “There are two major areas where you can find them in the brain, one is the center for learning and memory, called the hippocampus, and the other is around the brains' ventricles," Maletic-Savatic explained. Stem cells in the hippocampus are particularly useful, because memories always change, so the brain needs new cells with which to store and interpret them. Application and stem cell treatment for those with traumatic brain injuries is years away, but if a medication can be derived to target the brain’s ability to stimulate the neural cells to recreate, called neurogenisis, it would be a boon in brain injury treatment.

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Traumatic brain injury expert Gerard Gioia, PhD, Chief of Neuropsychology at Children’s National Medical Center and director of the Safe Concussion Outcome, Recovery and Education (SCORE) Program, has published a “10 steps’ successful concussion management program for children based on his work in the area. Currently, most concussion and TBI management programs for youth sports lag behind collegiate and professional sports. Yet the system is still unaware of the serious consequences of brain injury on a developing brain. “Implementing an effective sports concussion management program is essential to safeguard young participants and reduce long term risks,” writes Dr. Gioia. “Management of this serious injury must consider the various effects in the home, school, social and sports environments.” The program for mild traumatic brain injury (TBI)/concussion management is an easy to understand translation of the neuro-cognitive testing model used for professional athletes who have suffered from a mild TBI. It uses computer-based testing and standardized parent and teacher reports of the student athlete’s neuro-cognitive functioning. The SCORE program is funded by the Centers for Disease Control and Prevention (CDC). Research and education about proper treatment of mild TBI helps dispel ignorance among athletes, parents, coaches, teachers, and physicians about the serious and long term consequences of these injuries. The “ten steps” include defining more accurately when it is safe to return to the field and the classroom. Dr. Gioia is a primary author of the CDC tool kit that instructs physicians on proper diagnosis and management of concussions. The toolkit employs the Acute Concussion Evaluation (ACE), developed by Dr. Gioia and his colleague, Dr. Micky Collins, to improve the physician’s initial identification and treatment of mild TBI.

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Hypothermia therapy has been around for over 50 years and was used in heart surgery before the development of the heart-lung machine. A new application for hypothermia therapy is at the center of a pivotal trial underway in Houston at the Memorial Hermann-Texas Medical Center. The trial is intended for treatment of traumatic brain injury. Dr. Guy Clifton, a neurosurgeon began studying hypothermia’s effects after seeing TBI animals suffer less damage when their body temperature was cooled to two degrees below normal. The theory behind hypothermia’s benefit is that it causes a decrease in the metabolic rate, allowing the body to use less oxygen, controlling swelling while slowing the production of chemicals, harmful to the brain, released following a head trauma. In the 1990’s a similar study failed. The hope for the new study involves starting the cooling process earlier, within a couple hours, and using the therapy on those 45 or younger. In the failed study, Clifton found that those who had good outcomes either were admitted soon after injury or came in with a body temperature already below normal. Further, those who were older fared worse rather than improved. Dr. Gregory O'Shanick, national medical director for the Brain Injury Association, and Dr. Clifton express optimism that the current trial will vindicate the therapy.

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Based on a survey conducted in the U.K. and thought to be the first of its kind, victims of brain injuries are experiencing disturbing levels of isolation, discrimination and prejudice. Of greater concern is that the discrimination not only comes from social prejudice, but in the lack of care and attention from the healthcare industry. According to the survey, 60% of respondents had experienced discrimination from at least one service, such as health or social care, benefits or employment and more than two thirds of brain injury survivors believe they are socially discriminated against. The survey also revealed that respondents have experienced a lack of post-acute health care, difficulties in obtaining benefits or poor treatment from social services. One case in point is Kirsty Offord’s, she regularly faces prejudice as a result of her brain injury. “My brain injury is largely invisible,” she said. “Yet ten years on I still battle with daily life and I have to suffer abuse as a result. I've been verbally abused by a bus driver while trying to use my disabled pass as he thought I was a fraud, been humiliated by a library receptionist when I was struggling to fill out a form and my balance problems mean I am often refused access to pubs on the assumption I'm drunk. Knowing you can't do all the things you once could knocks your confidence enough, without being humiliated in public as well. I'm often treated like a second class citizen just because people are too quick to judge,” she added. The survey conclusions are a good indication of what Americans with brain injuries are experiencing stateside.

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In a laboratory environment researches studied the effects of early lead exposure and the brain’s ability to recover from brain injury. Exposure to lead early in life is already known to increase the risk of cancer, renal disease, hypertension and cardiovascular disease later in life and as a result, increasing the risk of stroke and brain damage. Researches already found that brief exposures to lead affected important factors in the brain used for growth and maintenance of neurons and their connections and other forms of brain plasticity. Dr. Jay Schneider, Ph.D., professor of Pathology, Anatomy and Cell Biology and Neurology at Jefferson Medical College of Thomas Jefferson University in Philadelphia said, “Brain plasticity generally refers to the brain's ability to be molded by experience as well as its ability to reorganize anatomically and functionally and recover from injury. It's why people who have relatively small strokes can recover function. The brain has an innate ability to reorganize and repair itself. Our data suggest that lead exposure may compromise or alter this capacity for remodeling that may impair recovery of function following brain injury.” The researches would like to see if such a trend translates to recovery from injuries such as traumatic brain injury. They would also like to explore the notion that childhood lead exposure increases the risk of a child having a poorer outcome from an acquired brain injury.

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