In the mid-1990s, the Standardized Assessment of Concussion (SAC) was discovered to assess minor brain injuries. The SAC assessments consisted of orientation to time, day, and date, immediate recall, concentration, and detailed recall. SAC screening became a popular tool for various sports to determine a person’s head injury. Recognizing a mild traumatic brain injury (mTBI) or concussion is crucial, and although mTBI/concussions are common, there is no specific diagnostic tool to determine the severity of the injury.

The SAC assessments soon created the Sports Concussion Assessment Tool (SCAT). After, the Department of Defense created their version of a SAC assessment called the Military Acute Concussion Evaluation (MACE). All three assessments became useful for their practices and helpful tools for non-sport related mTBI, but have resulted to have mixed results.


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On average, the 13-point Glasgow Coma Scale, otherwise known as GCS, is a routine part of the trauma triage on a worldwide level. GCS is a neurological scale created with the goal to provide a way of recording the conscious state of a person and their overall assessment. However, a recent study has found there may be simpler and more efficient methods to determine a patient’s consciousness.

A study published in the Annals of Emergency Medicine entitled “A Two-Center Validation of ‘Patient Does Not Follow Commands’ and Three Other Simplified Measures to Replace the Glasgow Coma Scale for Field Trauma Triage,” which analyzed trauma center registries in California and Colorado and ranged from 2003 to 2015. Nearly 50,000 trauma patients were analyzed.


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The New York Times recently published an article detailing a new study which examined people suffering from traumatic brain injuries (TBIs) and found an increased likelihood in developing dementia. The risk of developing dementia was highest in those who had suffered multiple TBIs, but even those who suffered from a single mild TBI were still at an increased risk of dementia.

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I often am contacted by individuals who have sustained traumatic brain injury (TBI) and have later been diagnosed with multiple sclerosis (MS). Many have asked me if their multiple sclerosis diagnosis was caused by their earlier trauma. Previously, most research I had read indicates that there is no causal relationship between MS and TBI.

However, I recently came across an interesting article published in January 2012 entitled “Increased Risk of Multiple Sclerosis after Traumatic Brain injury: A Nationwide Population-Based Study.”
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The United States District Court for the Southern District of Florida has ruled that diffusion tensor imaging (DTI) satisfies the Daubert standard for admissibility. Marsh v Celebrity Cruises, Inc., Case No. 1(17-CV-21097-UU.

In this case, the plaintiff was injured when she fell on a puddle of water on the Solarium floor of a Celebrity Cruise ship. As a result of the fall, plaintiff sustained a mild traumatic brain injury (TBI).

The plaintiff retained Gerald York, M.D., a board-certified neuro-radiologist and radiologist as an expert witness. Dr. York is the Director of TBI Imaging ARA/IA and a staff neuro-radiologist at the Providence Alaska Medical Center and also works as a consultant to the Defense Veterans Brain Injury Center. Additionally, he participated in the development of approved protocols for neuroimaging of the brain and contributed to the American College of Radiology’s Guidelines for Neuroimaging.


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According to the American Academy of Pediatrics, although the majority of concussions that are diagnosed annually occur in children, clinical guidelines are usually based on adult concussion sufferers. The lack of guidelines may limit the ability of pediatricians to accurately predict the duration of a child’s symptoms, including headaches, fatigue, and concentration problems — which can interfere with school and other activities.

In many concussion cases, concussion symptoms last only a few days. However, up to 25 percent of children have prolonged concussion symptoms which can last for months.

Concussion Symptom Saliva Test Study Presented at Annual Meeting

New research presented at the 2017 Pediatric Academic Societies (PAS) Meeting suggests that a saliva test for children may offer answers as to how long concussion symptoms will last. Researchers presented an abstract of the study, “Peripheral microRNA patterns predict prolonged concussion symptoms in pediatric patients.” The PAS Meeting is produced through a partnership of four organizations: Academic Pediatric Association, American Academy of Pediatrics, American Pediatric Society, and Society for Pediatric Research.


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A recent study found that concussions in adolescents can increase the risk of developing multiple sclerosis (MS) later in life. The risk increased substantially if the individual had suffered multiple head injuries as an adolescent.

What Causes MS?

Multiple Sclerosis is a disease of the central nervous system that “disrupts the flow of information within the brain, and between the brain and body.” Multiple sclerosis (MS) involves an immune-mediated process whereby the body’s immune system responds abnormally, targeting the central nervous system, including the brain, spinal cord, and optic nerves. Within the central nervous system, the immune system attacks myelin, the fatty substance that surrounds and insulates the nerve fibers, and the nerve fibers themselves. The damaged myelin forms scar tissue, which impacts and interrupts nerve impulses to and from the brain and spinal cord.


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A recent study evaluated the impact of financial compensation on late mortality after traumatic brain injury (TBI). The findings suggest that compensation may reduce late mortality risk.

To determine the impact of financial compensation on long-term mortality in adults with severe TBI, the outcomes of 2545 adults discharged from three post-acute inpatient rehabilitation services were analyzed. Compensation data were available for 1851 participants, with 826 receiving financial compensation. The study noted that yearly standardized mortality ratios were elevated above general population norms for six to ten years in both groups.


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