130px-413px-RobertFudd17Jh.png Once again a tip of the blog goes out to Mind Hacks for a great pointer. There is a new portal on Wikipedia dedicated to the Mind and Brain. Already there is a great group of people contributing information, and as more do so, the library of information on the brain will only improve. At the bottom of the page there are links to articles which need to be cleaned up or added. If you are knowledgeable about or have a background in neuroscience or the brain, jump on in and get involved.

I was recently sent an interesting article reporting on an evidence-based review of the literature from 1998 – 2002 about cognitive rehabilitation for people with traumatic brain injury.

This article is extremely important as it supports the use of cognitive remediation for people with traumatic brain injuries. In the past, insurance carriers and defense medical examiners have asserted that there is no scientific validity to cognitive remediation. This outstanding review of the literature clearly refutes that position and supports the use of cognitive remediation.

Previously, the American Congress of Rehabilitation Medicine‘s (ACRM) brain injury interdisciplinary special interest group conducted an evidence-based review of the literature through 1997 about cognitive rehabilitation for people with traumatic brain injury or stroke. That review led the group to make several specific recommendations concerning the clinical practice of cognitive rehabilitation and its effectiveness in TBI and stroke patients.

The purpose of the literature review was to update the previous evidence-based recommendations. The study originally selected for inclusion 118 articles but on later review excluded 31 of those studies.

The authors concluded that there was substantial evidence to support cognitive rehabilitation with people with TBI, including strategy training for mild memory impairment, strategy training for post acute attention deficits and interventions for functional communication deficits. The study called for future research to move beyond the simple question of whether cognitive rehabilitation was effective and to examine the therapy factors and patient characteristics that optimize the clinical outcomes of cognitive rehabilitation.

The article can be found in Arch Phys Med Rehabil Volume 86, August 2005.

Osborne v. Budd

This week’s New Jersey Law Journal’s Suits & Deals section mentions a case which I recently settled for a client.

On April 30, 1998 defendant Brenda Budd was traveling on Route 206 when she suddenly crossed lanes striking my client Gail Osborne’s vehicle. Ms. Osborne was taken to the emergency room, complaining of neck pain and released shortly that day. Over the next week, she began to experience problems with attention and concentration as well as balance. A CT scan taken shortly after the collision was normal. She was ultimately referred to Kessler Institute for Rehabilitation where she underwent neuropsychological testing and was diagnosed as having sustained a mild traumatic brain injury.

Following her discharge from the Kessler program, Ms. Osborne remained under the care of various specialists including a neuro-optometrist, neuro-otologist and neuropsychiatrist. The Social Security Administration found her to be totally disabled as a result of her injuries.

The defendant, Brenda Budd, and her attorney initially asserted that the collision occurred due to a defect in her vehicle’s axle. However, her insurance carrier, Liberty Mutual, got rid of the car prior to litigation so no testing could be done. Our lawsuit was instituted against Ms. Budd and a count for spoliation and punitive damages were asserted.

Trial was first commenced in the summer 2003. However, a mistrial was declared after plaintiff’s opening statement due to references to my client’s Social Security award. The case was next scheduled for trial in October 2003. After a three-week trial with the jury apparently hung, a second mistrial was declared when one of the deliberating jurors advised that she could not return for further deliberations.

The case was called for trial again on June 1, 2005 and after two days of negotiations I was able to settle the matter for $975,000.00.

Anthony Risser over at BrainBlog has an interesting post which links to a recently published story from The Miami Herald (registration required). The narrative is from a writer for The Herald and includes a good description of the resolution of her post-traumatic amnesia (PTA) (also called post-traumatic confusional state) in the recovery from the head injury she sustained.

You can read Anthony’s post here to access the story.

Talarick v. Domino’s Pizza A pedestrian struck by a Domino’s Pizza deliveryman and left brain-damaged will receive $1.2 million under an August 31, 2004 settlement. On December 23, 2002, Gerard Talarick was in the roadway of Bustleton Road in Burlington New Jersey tending to his dog which had been hit by a vehicle, when the Domino’s van hit him. He suffered a fractured skull, with bleeding in the brain, and other injuries. He needed emergency surgery to repair punctured intestines and later has two rotator cuff operations. Continue Reading Pizza delivery person will pay $1.2 million

Traumatic brain injury is often called the silent epidemic. This poses a problem for the trial attorney in obtaining compensation for his or her client. In many states, in order to recover fair compensation, the attorney must show objective evidence of a brain injury in order to convince skeptical jurors that the injury and problems are real. Unfortunately, traditional diagnostic studies such as MRIs and CT scans, usually show brain functions as normal, especially in mild traumatic brain injuries.

A more recent test that is becoming widely recognized in the scientific and medical communities is PET scans. Continue Reading PET scans – a more effective tool in detecting brain injuries