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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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Data from a recent study show that the use of golf carts has caused significant injuries in children under the age of 17, including brain injuries. Golf carts are somewhat inaccurately named as their use goes far beyond the golf course.

Golf carts are used in many communities in addition to golf courses, including retirement communities, farms, and shore communities. In fact, while many golf cart-related injuries do occur on the golf course, up to 30 percent occur on public streets, yards, and farms. In both Pennsylvania and New Jersey, golf carts are exempt from registration requirements. There are few regulations relating to them.

Study Shows Increasing Number of Golf Cart Injuries

Researchers evaluated approximately 100 children under age 17 treated in Pennsylvania trauma centers for injuries sustained in golf cart accidents over an 11-year period.

Twenty seven percent of the children injured in golf cart accidents suffered a concussion. The risk for concussion was found to be higher for children ages six to 11, compared with kids under six. Twenty five to 30 percent sustained intracranial injury and brain bleeding. One child died.

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A New York trial court recently denied defendants’ motion to compel plaintiff’s radiologist to produce Diffusion Tensor Imaging (DTI) control group data.

In Siracusa v. City Ice Pavilion, LLC, the plaintiff was injured while participating in an ALS Ice Bucket Challenge, held at a hockey rink owned and operated by the defendant. Plaintiff sustained a traumatic brain injury (TBI), allegedly at the fault of the defendant. Plaintiff underwent an MRI-DTI which was analyzed by Dr. Michael Lipton. Dr. Lipton’s DTI analysis lead to the conclusion that the plaintiff has abnormally low FA levels, which is consistent with traumatic axonal injury, although also consistent with other non-traumatic causes.

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According to the Chronic Effects of Neurotrauma Consortium (CENC), nearly 20 percent of the 2.5 million service members and veterans who deployed to Iraq and Afghanistan sustained at least one mild traumatic brain injury (mild TBI).

A U.S. Department of Veterans Affairs/Department of Defense study aims to track mild TBI (mTBI) over a decades-long period. The federally-funded study is enrolling service members and veterans who fought in Iraq or Afghanistan. Researchers hope to follow participants for 20 years or more to better understand the long-term neurologic effects of mild TBI and other deployment-related conditions.

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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.

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