Two recent peer reviewed papers support the position statement adopted by the Brain Injury Association in 2009 that “Brain Injury” be treated not as static event from which patients gradually recover over time, but as the beginning of a disease process that that can cause symptoms that change over time, in some cases getting worse instead of better, and that can impact multiple organ systems.
The good news is that most people do, in fact, recover. For those who do not, however, the disease model is more consistent with the evolving research. As McCrea, Iverson, McAllister, et. al. noted in their 2009 Integrated Review of Recovery after Mild Traumatic Brain Injury, brain injury science has advanced more in the last few years than in the previous 50, causing us to change the paradigms we have used to understand both the injury and its consequences. Read More
In July, 2013 the Defense Centers of Excellence, serving the United States Department of Defense, issued important new guidelines for neuroimaging following “mild” traumatic brain injury. The guidelines begin with the well-accepted understanding that neuroimaging is not typically included in the diagnosis of mild traumatic brain injury(“mTBI”) because only 10-15% of people who sustain trauma resulting in mTBI will have an acute brain lesion on CT (computed tomography) scans. “The lack of positive imaging findings,” the guidelines emphasize, “does not invalidate a diagnosis of mTBI.”
What is significant about the guidelines is that they recommend imaging in mTBI cases where the victim has “new, persistent or worsening symptoms” 90 days or more following the injury (described as the “chronic stage.”) Read More
Oscar-nominee Lucy Walker’s captivating new HBO documentary film about Vermont snowboarder Kevin Pearce provides extraordinary insight into the impact of a traumatic brain injury on both the victim of the injury – in this case an Olympic gold medal contender – and his family. The film, which recently premiered on HBO, will most certainly have a profound impact since it is both thrilling and entertaining – and therefore likely to be watched by many – and at the same time provides important, often misunderstood, information about the long-term physical and emotional impacts of the injury as well as the secret to finding a fulfilling life following a traumatic brain injury. Read More
On June 28, 2013 a Chittenden County Vermont jury returned a $43.1 million dollar verdict in favor Dzemila Heco, a 51 year old woman who suffered a C4-C5 spinal cord injury when her 1999 Dodge Neon was struck from behind at 35 miles per hour by another car while waiting at a red light. Read More
Concussion, or mild traumatic brain injury (TBI), typically produces no gross pathology, such as hemorrhage or abnormalities, that can be seen on conventional CT scans of the brain. It does cause rapid-onset neurophysiological and neurological dysfunction that in most patients resolves spontaneously over a fairly short period of time. Studies have shown, however, that approximately 15% of individuals with mild TBI develop persistent cognitive dysfunction and other symptoms. Researchers are starting to make progress on proving mild traumatic brain injury using the biomarkers that underlie such symptoms. Read More
Researchers at the Albert Einstein College of Medicine have just published a study in the peer-reviewed journal Radiology showing that soccer players who “head” the ball with high frequency show abnormalities in the white matter of their brains and poorer memory scores on cognitive tests. Read More
On June 4, 2013, Vermont’s Governor Peter Shumlin signed a bill that imposes greater requirements on schools to protect student athletes from the potentially serious consequences of concussions in sports, especially from multiple concussions.
Under prior law, coaches were required to keep athletes who they had “reason to believe” had sustained a concussion out of play until cleared to return by a qualified health professional. The new law imposes a similar requirement on a coach or health care provider who “knows or should know” that the athlete has sustained a concussion. Read More
The American Academy of Sleep Medicine has announced the results of a recent study showing that bright light therapy following Mild TBI (concussion) may improve sleep, cognitive and brain function. The study results were presented at the June 3, 2013 meeting of the Associated Professional Sleep Societies LLC and published in an online supplement to the journal Sleep. Read More
The topic of sexual dysfunction after a traumatic brain injury shouldn’t be taboo. Millions of people in the United States live with the physical, cognitive and emotional consequences traumatic brain injury (TBI). Sexuality is often impacted, but not often discussed or addressed. Failure to address this issue can compound the adverse effect of TBI symptoms on important relationships and self-esteem. NeuroRehabilitation: An International Journal recently published a critical review of fourteen studies on this topic. Read More
In the study, NYU medical school researchers measured changes in global and regional brain volume over a one year period in 30 patients with “mild” traumatic brain injuries and typical post-injury symptoms including anxiety, depression and fatigue, and other symptoms such as headache, dizziness and perceived cognitive problems.
