Brain Injury Blog

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Singer Bret Michaels the (former group Poison front man) was rushed to the hospital. According to reports, Bret was in excruciating pain, complaining of a headache that felt like he was “getting hit in the head with a baseball bat over and over again. A relatively typical symptom of a subarachnoid haemorrhaging!

Usually patients say it’s the worst headache of their life says Dr. Nicholas Bambakidis a neurosurgeon at the University Hospitals Case Medical Center in Cleveland, Ohio.

According to the Mayo Clinic, in any given year, an estimated six million people in the U.S. have aneurysms, but only a small percentage of those aneurysms will haemorrhage. According to the Mayo clinic’s website, a brain aneurysm is a bulge or ballooning in a blood vessel in the brain. It often looks like a berry hanging on a stem. A brain aneurysm can leak or rupture, causing bleeding into the brain (hemorrhagic stroke). Most often a ruptured brain aneurysm occurs in the space between the brain and the thin tissues covering the brain. This type of hemorrhagic stroke is called a subarachnoid haemorrhage. A ruptured aneurysm quickly becomes life-threatening and requires prompt medical treatment.

Ruptured aneurysm: A sudden, severe headache is the key symptom of a ruptured aneurysm. This headache is often described as the “worst headache” ever experienced.

Common signs and symptoms of a ruptured aneurysm include: Sudden, extremely severe headache, nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, a drooping eyelid, loss of consciousness, confusion.

Date: April 2010

F.Y.I.  A recent CDC report found that an estimated 1.7 million people sustain a traumatic brain injury (TBI) in the U.S. each year. This would be approximate 4,700 TBI’s per day. Fifty-two thousand people die each year in America from traumatic brain injuries, representing nearly one-third of all injury deaths. The majority of TBI’s that occur each year are concussions or other forms of mild TBI. - March 2010

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What is Chronic Traumatic Encephalopathy (CTE) it is a degenerative disease brought about by repetitive head trauma. It is the possible consequence of recurrent concussions. One such sport where this form of progressive brain damage can occur in is “Football”.

Originally diagnosed in boxers, this disorder is now being seen in other athletes. Its neuropathology is similar to Alzheimer’s disease. The symptoms include memory impairment, emotional instability, erratic behaviour, depression, and problems with impulse control.

One such individual that suffered from chronic traumatic encephalopathy was football player Tom McHale a 9 year NFL veteran. Tom was found deceased in a friend’s apartment on Sunday May 25, 2008 at the young age of 45.

To date, the youngest case discovered by doctors where chronic traumatic encephalopathy was in an 18 year old male whose brain showed evidence of the beginnings of brain damage that may have lead to CTE (Smith, S., January 27, 2009). He is the youngest to date; he was a multiple-sport athlete who suffered multiple concussions. He is the youngest known athlete to date.

So what is the message? That recurrent concussions may lead to permanent neurological changes in the brain resulting in permanent clinical behavioural symptoms needs to be communicated to athletes and parents at all levels of sports.

Source: BRAININJURYFORUM.com

Riley Joyce, the first baby to receive the treatment United Kingdom

(PhysOrg.com) - In a world first, xenon gas has been successfully delivered to a newborn baby in a bid to prevent brain injury following a lack of oxygen at birth. This pioneering technique was developed by Professor Marianne Thoresen of the University of Bristol and carried out at St Michael’s Hospital, part of University Hospitals Bristol NHS Foundation Trust.

Every year in the UK, more than 1,000 otherwise healthy babies born at full term die or suffer brain injury caused by a lack of oxygen and/or blood supply at birth. This can lead to lifelong problems such as cerebral palsy.

The use of xenon gas to prevent brain injury was developed by Professor Thoresen with Dr. John Dingley of Swansea University, in a study funded by Sparks, the children’s medical research charity.

The University of Bristol and St Michael’s Hospital have pioneered new treatments for brain injury in babies since 1998 when Professor Thoresen first started cooling babies after a lack of oxygen and showed that this technique could reduce damage in the newborn brain.

Professor Thoresen’s original laboratory work from 1995 had shown that cooling after lack of oxygen reduced brain injury in animal models. Clinical trials in humans then proved that mild cooling by only a few degrees for 72 hours is a safe and beneficial treatment. However, cooling only partially reduces disability and does not prevent it in all babies. The search thus began for a second treatment that could be added to cooling to further reduce disability.

Professor Marianne Thoresen said: “Xenon is a very rare and chemically inert anaesthetic gas found in tiny quantities in the air that we breathe. In 2002 John Dingley and I realised the potential xenon and cooling might have in combination to further reduce disability. Over the past eight years, we have shown in the laboratory that xenon adds to the protective effect of cooling on the brain; however we faced the challenge of how to successfully deliver this rare and extremely expensive gas to newborn babies.”

Dr. Dingley has been developing equipment in Swansea for xenon anaesthesia in adults for over 10 years and has invented a machine to successfully deliver the gas to babies. His machine takes the exhaled gas, removes any waste products from it and re-circulates it to be breathed again without any loss at all to the outside air. Some types of specialist military diving equipment work in this way but it is very unusual to build a system small enough to work reliably in newborn babies.

Dr. Dingley said: “A key design feature of this machine is that it is very efficient, using less than 200ml of xenon per hour - less than the volume of soft drinks can. Xenon is a precious and finite resource and difficult to extract so it can cost up to £30 per litre. As even newborns breathe many litres of air per hour, any xenon based treatment would be impossibly expensive without an economical delivery method.

“Despite these challenges, the lack of side-effects and brain protecting properties of xenon make it uniquely attractive as a potential treatment to apply alongside cooling in these babies. We are very grateful to Sparks, the children’s medical research charity, for supporting us in making this happen.”

Following rigorous Medicines and Healthcare Regulatory Authority approvals and other regulatory challenges, the device is now authorised for clinical trials and will be used on a minimum of 12 babies over the coming months. Successful completion of this feasibility trial is the first required step before larger trials can be done in baby units on a larger scale.

Provided by University of Bristol

Source: PhysOrg.com

Here is a story that defies the average person…..

It’s not every day that Major John Bini, a U.S. military surgeon, dons body armor before going into the operating room. But he did just that after an Afghan soldier was brought in on March 18 with an unusual head wound—a nearly three-inch unexploded shell lodged in the patient’s scalp.

After realizing the foreign object was a live explosive, Bini evacuated the operating room, leaving only the anaesthesiologist, Major Jeffrey Rengel, who put on body armor, to watch the patient. All electrical monitoring devices were turned off for fear of detonating the round, and a military bomb squad was called in. Using manual blood pressure cuffs and a battery-operated heart monitor to keep track of the patient’s vital signs, Bini operated with only Rengel in the room along with a member of the bomb team.

Bini safely removed the ordinance from the man’s skull. The patient did suffer a traumatic brain injury, but his neurological condition continues to improve. The surgery was performed at the Craig Joint Theater Hospital at Bagram Airfield. - Noel Brinkerhoff

The President of the High Court, Mr Justice Nicholas Kearns, has established a working group to examine how damages are paid in catastrophic injuries cases. Here he outlines the background

DAMAGES IN personal injury cases are awarded on a one-off or lump sum basis. In the vast majority of cases, the awards reflect an attempt by the courts to ensure that a claimant is adequately compensated for the damage done and for the injuries suffered. Adequate compensation can be defined as compensation intended to place the plaintiff in the position he would have occupied if the injury had not been suffered, insofar as that objective can be achieved by an award of money.

To read the balance of this article, click on the link below:

http://www.irishtimes.com/newspaper/ireland/2010/0412/1224268133877.html

Source: IRISHTIMES.com April 12, 2010

Like 1.4 million people every year, Bob Woodruff suffered a brain injury.

Now medical breakthroughs offer miracles of recovery. 

September 6, 2008, was a clear-blue Indian summer day in Nebraska. Jennifer Ruth sat in the stands and watched her 12-year-old son, Derek, run with the football. She was unconcerned when he was tackled in a routine play. But as he fumbled the ball, she remembers seeing his right arm drop oddly, almost in slow motion. “He never does that” flickered through her mind. The coach noticed a glazed look on Derek’s face in the team huddle. He pulled him aside and asked him for the date, score, and his brothers’ names. Derek answered correctly. Then, minutes later, he screamed, “My head,” pulled off his helmet, and collapsed.

Derek was taken to a trauma center and went into surgery. After several weeks in the ICU and months of therapy, he is regaining his physical and cognitive abilities. At first, he could only give a thumbs-up or thumbs-down response to questions; now he reads at a sixth-grade level and tackles algebra problems.

A decade ago, Derek’s prognosis might not have been hopeful. But thanks to advances in the treatment of traumatic brain injury (TBI), the outlook for patients has dramatically improved. “Research points to the amazing regenerative powers locked in our brains,” says Dr. Col. Rocco Armonda, senior Army neurosurgeon at Walter Reed Army Medical Center in Washington and at Bethesda Naval Hospital in Maryland. “The proper therapies can help with the unlocking.”

Each year, 1.4 million people in our country sustain brain injuries, and 9% will end up with lifelong impairments. Causes of TBI include car accidents, playground accidents, falls by the elderly, and domestic violence. According to the U.S. Centers for Disease Control and Prevention, 3.2 million Americans are living with long-term disabilities from brain injuries. This figure does not include the estimated 320,000 veterans from the wars in Iraq and Afghanistan who have TBI, according to the latest statistics.

You may think you don’t know anyone with a brain injury, but they’re all around you. One could be the person you see lose his temper with the store clerk because sports-induced concussions left him short-fused. Another could be your neighbour who keeps locking her keys in the car or the man who looks healthy but needs a few tries to push a revolving door.

Despite its prevalence, brain injury bears a stigma. To many of the uninitiated, a person with TBI equals “slow” or “retarded.”

I used to be one of the uninitiated. Then, in January 2006, my husband, Bob, was injured in Iraq by a roadside bomb while covering the war for ABC News. Hundreds of pieces of rock shrapnel became embedded in his face, neck, and back, and his skull was shattered. Doctors were unsure whether he would ever be able to walk or talk again or regain much mental function. They also told me that if and when he regained consciousness, I could expect that his healing would be largely concluded by the end of two years.

Bob spent 36 long days in a coma. When he woke up, his abilities were severely limited. I watched, devastated, as he could not identify words like “scissors” or “helicopter.” But he was determined for the sake of our family to recover, and he devoted himself to rehabilitation. Today, apart from mild aphasia—difficulty in finding the appropriate word to use—he is back as a husband and father and on the air as a journalist at ABC News.

While each injury and recovery is as varied as the patient affected, scientists now know that the healing process in the brain can go on much longer than originally believed. For instance, even three-and-a-half years after the bomb blast, Bob’s speech continues to get more fluid.

Innovations in cognitive rehabilitation have played a key role in improving people’s outcomes. Twenty years ago, rehab consisted of rote memorization, repetition, and trying to get patients to meet certain benchmarks. “One of the advancements in rehabilitation is to make the therapy person-centered,” says Dr. Lori Terryberry-Spohr, brain-injury program manager at Madonna Rehabilitation Hospital in Lincoln, Neb. “We can tailor it to the individual’s goals, strengths, hobbies, interests, and occupations.”

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Physical, psychological function loss after brain injury studied

Loss of physical, psychological function after traumatic brain injury not related to injuries in brain structure.

It has been thought that the loss of physical and psychological function after traumatic brain injury is closely related to injuries in brain structures. However, in the current edition of Deutsches -rzteblatt International Doctors have discovered something different.

To read the recently discovered finding, follow the link provided below:

http://www.upi.com/Science_News/2010/03/30/Function-loss-after-brain-injury-studied/UPI-12371269975914/

Source: UPI.com - March. 30, 2010

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The use of the progesterone hormone as treatment for traumatic brain injury is fairly new and still being tested in clinical trials. It has been shown IV infusion of progesterone to trauma victims shortly after brain injury occurs can reduce the risk of death or long-term disability by up to 50 percent.

Progesterone is a hormone that is naturally present in both male and female brains. It is critical for normal brain development and also has protective effects on damaged brain tissue. In order for the hormone to have the most beneficial effects, it must be administered to the patient as soon as possible following brain injury. Administering progesterone has proven to be safe with no adverse effects.

So far in clinical trials, progesterone has decreased disability and improved functional outcome on the classic TBI outcome measures: the Disability Rating Scale and the Glasgow Outcome Scale.  Experts say progesterone could be the first approved treatment for traumatic brain injury in over 30 years.

Source: Emery University 04/2010

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“Treatment of TBI builds upon KMI’s neurotherapy technology platform”

TEMPE, Ariz.- (BUSINESS WIRE) -Kinetic Muscles Inc. (“KMI”, www.kineticmuscles.com), a leading innovator of neurorehabilitation technology, announced it has received a 2-year Phase II SBIR grant to study a new treatment for veterans returning from active duty with traumatic brain injury (TBI).

Promising results from a Phase I study which combined neuropsychological therapy and digital gaming technology led the DoD to fund this Phase II study that will validate effectiveness of the therapy system through clinical testing in VA hospitals.

KMI will collaborate with Emory University, Division of Neuropsychology (Atlanta, GA), the DoD, the VA, and the University of Advancing Technology (Tempe, AZ) which is recognized as one of the foremost ‘gaming’ schools in the nation.

TBI is not only the most prevalent injury affecting today’s soldiers, but is also a major health issue for the general population. The Centers for Disease Control and Prevention (CDC -TBI) report that 1.7 million Americans are affected by traumatic brain injury each year and there are 5.3 million people with permanent TBI-related disability in the United States.

Clinical studies have shown that videogame-based therapies such as those used in KMI’s Hand Mentor™ can improve cognitive ability, dexterity, memory, thought processing, and reasoning. Therapy interventions incorporating both state-of-the-art gaming technology and cutting edge cognitive and motor rehabilitation strategies have the potential to be cost-effective and engaging particularly for a generation of soldiers who have grown up using videogames for entertainment.

“Treatment of TBI builds upon KMI’s neurotherapy technology platform,” said Ed Koeneman, Chief Operating Officer at KMI and Principal Investigator for the study. “Patients with stroke and TBI experience similar cognitive and movement deficits. KMI technology addresses rehabilitation for both groups through repetitive training of specific tasks.”

David Bolman, Provost of the University of Advancing Technology, added, “We are pleased to work with KMI and Emory University on this important project. This collaboration is representative of the merging of technologies that will shape healthcare in the future.” About Kinetic Muscles, Inc. www.kineticmuscles.com

Founded in 2001 in Tempe, AZ, KMI addresses the rehab therapy needs of patients suffering from stroke, traumatic brain injury (TBI), multiple sclerosis, incomplete spinal cord injury, and cerebral palsy. KMI is a thought leader in the field providing solutions that merge digital and robotic technologies with sound neurotherapy principles to deliver ‘Improved Outcomes for More Patients at Lower Cost’.

KMI products are used in leading rehabilitation clinics and by a growing number of patients in the home setting. Hand Mentor™, Foot Mentor™, and Active Repetitive Motion™ are trademarks of KMI.

Release: April 5, 2010