A recent study identified that 30 percent of mild traumatic brain injury (mTBI) patients experience unfavorable outcomes six months post-injury. The UPFRONT-study evaluated outpatient follow-up by health care providers in patients after mTBI. The study included both hospitalized and non-hospitalized patients.

Patients were recruited from 2013 to 2015 at trauma centers and were classified as mTBI patients under the European Federation of Neurological Societies (EFNS) guidelines. They were categorized as hospitalized or non-hospitalized (discharged directly from the emergency room). Of the 1151 patients included in the UPFRONT-study, 60 percent were admitted to the hospital; 48 percent were hospitalized for one day. The mean length of stay was 3.4 days.

Continue Reading UPFRONT-Study: Outpatient Follow-Up After Mild Traumatic Brain Injury

MRI of Brain InjuryIn 1848, Phineas Gage, a 25 year old railroad worker, unwittingly became a benchmark of modern neuroscience. Gage was using a tamping iron to pack explosives when a spark ignited the explosive charge, propelling the iron rod through his cheek, behind his eye socket, then upwards through his brain, finally exiting the top of his skull, and landing some distance away. Gage survived, despite the fact that the tamping iron had destroyed much of his left frontal lobe.

Continue Reading What Phineas Gage’s Injury Taught Us About Frontal Lobes

Mild traumatic brain injury (mTBI), commonly known as concussion, is the most common type of traumatic brain injury. Along with impaired cognitive function, mTBI causes an array of symptoms, including headaches, fatigue, depression, anxiety, and irritability, referred to as post-concussion syndrome (PCS). The time it takes for symptoms to resolve in the majority of individuals is thought to be approximately three months; however, some individuals continue to experience symptoms beyond that time period. Those with persistent symptoms are said to experience persistent post-concussion syndrome.

A widely cited figure suggests that only 15 percent of individuals experiencing a first-time concussion will go on to experience long-term cognitive impairment. A recently published research article suggests that this number is likely a gross underestimation.

Continue Reading Mild Traumatic Brain Injury and Chronic Cognitive Impairment

Traumatic Brain Injury (“TBI”) can happen to anyone at any time. The Centers for Disease and Control Prevention (“CDC”) reports that an estimated 1.7 million people sustain TBI annually in the United States. Of those people sustaining TBI, 52,000 die and 275,000 are hospitalized. Nearly 80 percent of those injured (1.365 million people) are treated and released from an emergency department.

The documentary “OVERCOMING” exposes how individuals cope with the consequences of Traumatic Brain Injury. Such consequences differ from person to person and due to the nature of TBI. Also, each person copes with the consequences of Traumatic Brain Injury in ways that differ for each individual. The goal of the documentary is to raise awareness of TBI and to provide information about its consequences.

The director/producer of the documentary, Katerina Dejkoska, is a filmmaker who was motivated by the lack of information and public awareness to explore the topic of Traumatic Brain Injury. The documentary focuses on moving on with positivity after sustaining TBI.

Traumatic brain injury (“TBI”) is considered the main cause of hypopituitarism in adults and growth hormone (“GH”) deficiency is the most common pituitary deficit associated with TBI.

According to Cedars-Sinai, even after we stop growing, adults need growth hormone. Growth hormone plays a role in healthy muscle, how our bodies collect fat (especially around the stomach area), the ratio of high density to low density lipoproteins in cholesterol levels, and bone density. In addition, growth hormone is needed for normal brain function.

Continue Reading Growth Hormone Deficiency Following Complicated Mild Traumatic Brain Injury

The Journal of Head Trauma Rehabilitation recently published an article entitled “Emergency Department Evaluation of Traumatic Brain Injuries in The United States, 2009-2010.” The article examined emergency department records from the national hospital ambulatory medical care survey in 2009 and 2010 where traumatic brain injury was evaluated and diagnosed either clinically or with head computed tomographic (CT) scans. A CT scan was performed on 82% of the TBI evaluations. Of those, only 9% had CT evidence of traumatic abnormalities.

The authors concluded the emergency department is the “primary gateway” to the medical system for patients with acute TBIs. However, emergency department evaluations have not been sufficiently described. This national study fills an important void.

Continue Reading New Study finds Emergency Room Physicians Often Fail to Diagnose TBI

At the annual meeting of the Association of Academic Physiatrists, Brad Kurowski, MD, MS, a physician in the division of Physical Medicine and Rehabilitation at Cincinnati Children’ Hospital presented his research on the long term effects of TBI among children.

Continue Reading Study Finds Long Term Effect of Mild Traumatic Brain Injury in Children Seven Years Post Injury

Have you ever wondered what happens within a person’s skull when he/she suffers a traumatic brain injury?

The New York Times recently published a wonderful interactive article about brain injuries. The article describes and demonstrates what happens within a football player’s skull when he suffers a concussion.

Using a mouth guard developed by bioengineer David Camarillo and his team the KAM lab at Stanford, the information gained from the mouth guard and its sensors enabled the researchers to recreate what happens to a player’s brain in a millisecond from the collision.

Included in the article is an interactive representation of what happens to one’s brain.

Click here to read the full New York Times article.

BlueCross BlueShield just released its Health of America Report showing that concussion diagnoses have increased 43% from 2010-2015. The rise was particularly marked in children and teens with a 71% rise in diagnosed incidences. Not surprisingly the rate in male patients during the fall season was double that of females. “Connecticut, Pennsylvania and Massachusetts had the highest rates of concussion diagnoses for patients 10-19. The study also reported an increase of 84% in post-concussion syndrome diagnoses with an interesting split–“more females then males ages 20-64 experienced post-concussion syndrome (61.3% vs. 38.7%).”

Some percentage of the increase could be attributed to a growing recognition of the long term impact of concussion, particularly the increased rate of suicide linked to the condition. However, it is disturbing that the concussion diagnoses increased in nearly every state from 2010-2015. The significant change raises questions on causation and indicates the need for more research.

In 2001, Teasdale and Engberg published an article in the Journal of Neurology, Neurosurgery and Psychiatry, entitled Suicide after Traumatic Brain Injury: A Population Study. The researchers reviewed data from Danish hospital admissions covering the years 1979-93 and found that patients who had sustained a TBI had an increased risk of suicide. The authors in that study concluded, “The increased risk of suicide among patients who had an MTBI may result from concomitant risk factors such as psychiatric conditions and psychosocial disadvantage. The greater risk among the more serious cases implicates additionally physical, physiological, and social consequences of the injuries as directly contributing to…suicide.”

In a recent research article, Lauren B. Fisher, et al. evaluated data from a brain injury-focused database, the BI Model Systems National Database, to further evaluate whether or not suicide rates are higher in TBI patients. Using patient health questionnaires detailing self-reported suicide attempts over a period of twenty years, the authors concluded that those who suffer a TBI are indeed at “greater risk for depression and suicidal behavior.” The outcome of the study indicates the need for “routine screening and mental health treatment in this population.”