Brain Injury Lawyer

Yesterday I attended a wonderful presentation at the IABA's 8th World Congress entitled, "mild TBI-Current Science and Future Directions". The speakers were Jim Kelly, MD and Erin Bigler, Ph.D. Dr. Kelly is recognized as one of the leaders in the field of concussion in sports and traumatic brain injury. Dr. Kelly is the director of the new National Intrepid Center of Excellence, an advanced facility dedicated to research, diagnosis and treatment of military personnel and veterans suffering from traumatic brain injury (TBI) and psychological health issues.  Dr. Bigler,  a professor of Psychology and Neuroscience at Brigham Young University is a recognized expert in the field of neuro-imaging and traumatic brain injury.

Dr. Kelly discussed the work that is being done in the military with our wounded soldiers (studies show that 15-23% of our soldiers screens for TBI after leaving Iraq and Afghanistan are positive for brain injury. Dr. Bigler discussed advances in neuro-imaging. What I found fascinating was that neuro imaging which previously was insensitive to mild TBI is now more sensitive than neuropsychological testing. Dr. bigler presented an example where testing on the CVLT was marginally abnormal (most neuropsychologists would say not significantly different) while the imaging detected the abnormality.

This week I am in Washington, DC at the International Brain Injury Association's 8th World Congress on Brain Injury. The Congress brings together world renowned experts in the field of brain injury to share their research with over 1000 registrants from over 40 countries around the world.

I attended a pre-Congress workshop on Neuropsychiatry of TBI, chaired by David Arciniegas, MD. For those interested in medical legal issues I was very excited to hear from Marilyn Kraus, MD who spoke on Diffusion Tensor Imaging in the Neurobehavioral Assessment of TBI. DTI promises to be such a wonderful tool in objectively documenting brain injury even for those with mild TBI.
 

Armed with Science, The Pentagon Channel's podcast program, presented an interview with Dr. Thomas Meitzler, a scientist at the U.S. Army Tank Automotive Research, Development and Engineering Center (TARDEC), and Dr. Joy Hirsch, professor at Columbia University and director of the Program for Imaging and Cognitive Sciences. In the podcast the doctors discussed a collaborative study to determine what areas of the brain are susceptible to damage for Traumatic Brain Injury (TBI) patients.

The interview noted that traumatic brain injuries, particularly for military personnel in Iraq and Afghanistan, is on the rise when soldiers come into contact with improvised explosive devices (IEDs). The doctors determined the science and technology of functional Magnetic Resonance Imaging (fMRI) used in the previous research could be used in TBI studies. You can read more on their study online here.

At this week's 8th World Congress on Brain Injury in Washington, DC. Dr. George Zitney was given a lifetime achievement award for his outstanding work on behalf of those with TBI. Dr. Zitney reviewed with us the history of the various brain injury organizations, acknowledging the courageous work of Marilyn Spivak, the founder of the Brain Injury Association. Dr. Zitney warned that we must be vigilant to make sure that brain injury research and the funding necessary for it is not lost or taken away due to the world economic problems.

Sir Graham Tesadale, MD was awarded the 2010 Jennett & Plum Award for Distinguished Scientific Contributions to the Field of Brain Injury. Sir Graham Teasdale is an Honorary Professor in the Section of Psychological Medicine. He was previously Professor of Neurosurgery, Head of the Department of Neurosurgery and Associate Dean for Medical Research. Along with Brian Jennett, he invented the Glasgow Coma Scale, or GCS, which is used in every hospital around the world to give a reliable, objective way of measuring the conscious state of a patient.
Sir Graham was President of the Royal College of Physicians and Surgeons of Glasgow from 2003 until 2006. He was knighted in 2006 for his services to neurosurgery.

Dr. Teasdale topic was “Progress in Understanding Severity and outcome following TBI. After discussing the history of the development of the Glascow Como Scale and the Glascow Outcome Scales, Dr. Teasdale reported on his present research in the field of brain injury outcomes. In 2000 Dr. Teasdale published a paper regarding outcome from severe, moderate and mild brain injury. What was so surprising from that research was that at 1 year post injury those with mild TBI had disability rates similar to those with more severe injury. In 2006 Dr. Teasdale published his findings of these people 5-7 ears since injury. This morning Dr. Teasdale, who is still following this patient group now 10-12 years post injury, spoke about the continued disability of those with brain injury through all classifications.

Again for those interested in forensic work Dr. Teasdale’s research totally dismisses the myth that everyone with mild TBI goes on to uneventful recovery. I certainly look for to the publication of this most recent work.

This year, 1.4 million people will sustain a traumatic brain injury. This number exceeds the number of breast cancer, HIV, multiple sclerosis, and spinal cord injuries combined. Additionally, in recent years, traumatic brain injuries have emerged as the "signature injury" of the conflicts in Iraq and Afghanistan with as many as 20% of soldiers sustaining brain injuries. Brain injuries remain a leading cause of death and disability in both children and adults.
 
The TBI Act, which was originally passed in 1996 and reauthorized in 2008, is the only federal law that specifically addresses the needs of the growing population of brain injury survivors. The programs authorized under the TBI Act provide public awareness and education through the Centers for Disease Control and Prevention and State TBI care capacity-building and protection, legal, referral, and advocacy services at the Health Resources and Services Administration.  Furthermore, the TBI Model Systems of Care at the National Institute on Disability and Rehabilitation Research (NIDRR) represent a vital national network of TBI research and expertise, providing the only source of non-proprietary longitudinal data on TBI experiences and a key source of evidence-based medicine.
 
Please join us in supporting these programs by sending the below letter to the House Appropriations Subcommittee on Labor-HHS-Ed requesting $22 million for the programs authorized by the TBI Act and $11 million for TBI Model Systems of Care.   
 

Dear Chairman Obey and Ranking Member Tiahrt:
 
The undersigned members of the Congressional Brain Injury Task Force, and other Members of Congress, respectfully request your support for $22 million for FY 2011 to fund programs authorized by the Traumatic Brain Injury (TBI) Act as amended in 2008 in the Department of Health and Human Services (HHS).  We also request $11 million for the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems administered by the Department of Education.
 
Known as the "silent epidemic," TBI continues to be the signature injury of the wars in Iraq and Afghanistan, and incidence is increasing here at home among our nation's civilian population.   From the battlefield to the football field, TBI remains a leading cause of death and disability in both adults and youth.  Primary funding to address this growing population is provided through these programs.
 
Therefore, we request funding for TBI-related programs in the following amounts:
  
* $10 million (+$4 million) for the CDC TBI Registries and Surveillance, Brain Injury Acute Care Guidelines, Prevention, and National Public Education/Awareness
* $8 million (+$1 million) for the HRSA Federal TBI State Grant Program
* $4 million (+$1 million) for the HRSA Federal TBI Protection & Advocacy (P&A) Systems Grant Program; and 
* $11 million (+$1.5 million) for the NIDRR TBI Model Systems Program
  
CDC - National Injury Center - We specifically ask for additional funding for CDC's National Injury Center will support continued work in tracking the incidence of TBI; the creation and dissemination of public and professional educational materials; coordination with the Departments of Defense and Veterans Affairs; and recent collaborations with the National Football League and National Hockey League to improve awareness of the incidence of concussion in sports.  Additionally, CDC plays a leading role in helping standardize evidence-based guidelines for the management of TBI, and $3 million of this request would go to fund CDC's work in this area as well as support a pilot project to improve hospital compliance with existing guidelines.
 
HRSA Federal TBI State Grant Program - Further, increased funding for the HRSA Federal TBI State Grant Program is necessary due to recent changes in the awarding of grants.  Beginning in FY 2009, HRSA increased each grant award from $118,000 to $250,000 resulting in a reduction in the number of state grant awards to 15.  This means that many States that had participated in the program in past years have now been forced to close their operations, leaving many unable to access brain injury care. 
 
Increasing the program to $8 million will provide funding necessary to sustain the grants for the 15 states currently receiving funding along with the three additional states added this year and to ensure funding for four additional states.  Steady increases over five years for this program will provide for each state including the District of Columbia and the American Indian Consortium and territories to sustain and expand state service delivery; and to expand the use of the grant funds to pay for such services as Information & Referral (I&R), service coordination and other necessary services and supports identified by the state. 
 
HRSA TBI P&A Program - Additionally, the state P&A systems-funded through the HRSA TBI P&A Program-serve to protect the legal and human rights of individuals with TBI.  P&A advocates must possess specialized skills, and their work is often time-intensive.  A $4 million appropriation would ensure that each P&A system can develop and operate comprehensive programs with appropriate staff time and expertise.
 
NIDRR TBI Model Systems of Care - Finally, enhanced funding for the NIDRR TBI Model Systems of Care will sustain the existing 16 TBI Model Systems research centers around the country and allow for the creation of one new collaborative research project.  These investments will ensure that this valuable TBI research capacity is not diminished.   The TBI Model Systems of Care represent a vital national network of expertise and research in the field of TBI.  In addition, given the national importance of this research program, the TBI Model Systems of Care should receive line-item status within the broader NIDRR budget.
 
We ask that you consider favorably these requests for the CDC, the HRSA Federal TBI Program, and NIDRR TBI Model Systems Program to further data collection, increase public awareness, improve medical care, assist states in coordinating services, protect the rights of persons with TBI, and bolster vital research.
 
Sincerely,   

If you have any questions or would like to sign on, please contact Mandy Spears in Congressman Pascrell's office or Becky Wolfkiel in Congressman Platts' office.

The Family Support Program at the Brain Injury Association of New Jersey has expanded its services due to additional funding from the New Jersey Department of Human Services, Division of Developmental Disabilities.  This program provides free care coordination services for people who have sustained an acquired brain injury before the age of 22 and for their families.  If you would like to learn more about this program, please contact Judi Weinberger, Director of Family Support, at (732) 745-0200 or jweinberger@bianj.org.

I was very pleased to learn that I have been re-elected to serve on the Board of Governors of the International Brain Injury Association.  IBIA is an international organization of professionals dedicated to work to improve outcomes and opportunities for persons with brain injury. Below is a complete list of the 2010 Board of Governors:

David Arciniegas, MD
Lucia Braga, PhD
Ross Bullock, MD, PhD
Enrico Castelli, MD
Chetwyn Chan, PhD
Esteban Fridman, MD, PhD
Tai Ryoon  Han, MD, PhD
Steven Laureys, MD, PhD
Jose Leon-Carrion, PhD
Peter Patrick, PhD
Claudio Perino, MD
Jennie Ponsford, PhD
Wai  Poon, MD
Bruce Stern, Esq.
Walter Videtta, MD
Kevin Wang, MD
Ross  Zafonte, DO
Nathan Zasler, MD
Mariusz  Ziejewski, PhD
 
From March 10 to 14, 2010, IBIA will be sponsoring the 8th World Congress on Brain Injury in Washington, DC.  You can access additional information online here.  I look forward to seeing everyone there.

Just a reminder that The Brain Injury Association of New Jersey will host its 2010 Annual Gala on Tuesday March 9, 2010 at the Hanover Marriott in Whippany, New Jersey. The Gala will celebrate the Brain Injury Association of New Jersey’s 25 years of service and dedication to the brain injury community and will honor individuals who have made significant contributions to advancing the quality of life in New Jersey throughout the past 25 years.

For additional information on the event and the honorees, please visit the Brain Injury Association of New Jersey’s website.
 

The Brain Injury Association of New Jersey will hold its Annual Brain Injury Awareness Day Monday, March 8, 2010 at the State House in Trenton, New Jersey. A tentative schedule of events for the day is listed below:

• Visit the display at the elevator lobby on the 3rd floor (near Café NJ) between 10:00 – 12:00 and learn about our programs and services.
• At 1:00 visit the Welcome Center Multi-Purpose Room as the BIANJ recognizes Assemblywoman Mila Jasey for being prime sponsor of law creating the New Jersey Special Education and Traumatic Brain Injury Task Force. 
• At 2:00 the Assembly Education Committee is expected to hold a hearing on sports concussion.

For additional information and/or to RSVP, please contact Tom Grady, Director Advocacy & Public Affairs,at 732-745-0200 or by email at tgrady@bianj.org.

Though the Olympics bring years of hard work and dedication to fruition for many athletes, for some it brings serious injuries. Snowboarder, Kevin Pearce, a favorite to challenge gold medalist Shaun White in the halfpipe, sustained a traumatic brain injury during training December 31, 2009. Pearce struck his head on the lip of the halfpipe while attempting a double cork - a move he had performed several times before. Pearce continues to show improvement and currently resides at Craig Hospital in Englewood, Colorado. 

Pearce's story is just one more reminder of the serious and devastating effects brain injuries can have on athletes, no matter their skill level. You can watch a video of Pearce's story online here.