Bruce Stern recently recorded a video blog where he discussed what traumatic brain injury is, they different types of TBI, and the various symptoms associated with brain injuries.
A recent Opinion Page article in the New York Times discusses the implications of covert consciousness on patients’ rights. Covert consciousness is a state of consciousness that cannot be detected by bedside examination. The author pointedly asks: “If there is a legal obligation to educate the developing brain, should there not be a correlative responsibility to those whose brains are in a process of redevelopment and recovery?”
The author writes about a patient who was participating in a study of patients with severe brain injury who exhibited the ability to use her left eye to answer simple yes or no questions with an eye tracking device. The young woman had suffered a complex stroke while in college and had been thought to be in a permanently unconscious “vegetative state.” She was subsequently found to be in the “minimally conscious state,” capable of demonstrating intention, attention, and memory.
While the Federal Aviation Administration (FAA) has addressed protection from head injuries for flight attendants, according to a recent article, it has not addressed the impact of shrinking seat designs on the safety of passengers. A second article states that no seat in coach meets the FAA’s standards for the space required for flight attendant seat safety.
Graphic Sheds Light on Impact of Smaller Seats and Rows on Safety
Embedded in the regulations governing commercial airline safety is a graphic that may offer evidence that smaller seats and rows on airplanes may affect passengers’ safety. The DOT graphic shows the “head strike zone” for a seated flight attendant and is intended to offer guidance on seat design to reduce the risk of injury to flight attendants during takeoff and landing but apparently a similar analysis has not been undertaken as to passengers.
Females experience concussions differently than males but there has been little research on the topic. Dr. Mayumi Prins, a professor of neurosurgery at the David Geffen School of Medicine at UCLA and director of the UCLA Brain Injury Research Center education program, is looking to change that. He notes that most research has focused on male concussion patients and therefore there is little information available as to the science as to why females may suffer more concussions and experience more prolonged symptoms.
Scientific research has shown that female and male brains differ in terms of activity patterns, anatomy, chemistry, and physiology. Concussions may affect females differently than males for a variety of reasons, including hormonal issues and differences in upper bodies – especially the way muscles in the neck react after collisions. Also, females may be more likely than males to disclose concussion-related symptoms such as headaches, diminished social interaction, and depression, according to Prins.
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.
When an individual suffers from a brain injury, the resulting cognitive, physical, social, and psychological effects often create challenges for that person. Other family members may also be affected, including spouses and children. A recent study investigated the emotional and behavioral impact on children when a parent has a severe acquired brain injury (ABI). ABI can result from trauma, illness, infection, brain tumors, or other conditions.
The study involved 25 couples that included one spouse who was affected by ABI, and their 35 children, ages three to 14 years. The children attended three sessions with a psychologist to identify their spontaneous playing and relational behavior through a grid created on the basis of ICD-10 criteria.
Chronic traumatic encephalopathy (CTE) was found in 110 of 111 (99 percent) brains of deceased former National Football League players that were donated to scientific research, according to a study published in the medical journal JAMA. CTE, a neurodegenerative brain disease, was also neuropathologically diagnosed in 177 of the 202 players studied across all levels of play (87 percent). It was found in three of the 14 high school players and 48 of the 53 college players.
CTE is typically found in individuals who have been exposed to repeated head trauma, including veterans and football players. CTE can only be diagnosed with an autopsy. The JAMA study focused on football as the primary exposure to head trauma, whether or not the individual had exhibited symptoms while living. The study acknowledged the lack of a comparison group without which the study cannot offer an estimate on the overall risk of brain injury due to participation in football.
Four Kessler Foundation researchers were awarded two-year grants to fund studies of functional and cognitive deficits in individuals who have experienced traumatic brain injury (TBI). The grants, totaling $713,000, were awarded by the New Jersey Commission on Brain Injury Research (NJCBIR).
Researchers will study functional and cognitive deficits in individuals with moderate to severe traumatic brain injury (TBI), including learning and memory, and limb mobility.
One grant, valued at $179,000, will fund a two-phase trial testing the “modified Story Memory Technique (mSMT)” in school-aged children. The mSMT trial will compare healthy controls with children who have cognitive deficits caused by TBI. The grant awardee, Dr. Nancy Chiaravalloti, previously conducted a study involving multiple sclerosis and mSMT which found that mSMT is effective for improving learning and memory in MS patients. Dr. Chiaravalloti is the director of neuropsychology, neuroscience and TBI research at Kessler Foundation, and director of the Northern New Jersey TBI Model System.
A recent review examined clinical and experimental literature for information on the long-term cognitive impact of traumatic brain injury (TBI) in the context of cognitive aging.
Neurobiological changes take place as part of the normal aging process. The issue evaluated through the literature is whether those individuals who experience cognitive problems as a result of TBI are at risk of accelerated and premature aging, and dementia.
Much of the recent research concerning mild traumatic brain injury (mTBI) has focused on professional athletes and military veterans. This research may not apply to individuals with mTBI whose injuries result from other causes, including motor vehicle collisions and falls.
Autopsies of individuals with these types of injuries indicate that mTBI causes diffuse axonal injury and micro hemorrhages. Until recently, however, it was not possible to examine microstructural pathology in living persons because of the insufficient sensitivity of computed tomography and conventional magnetic resonance imaging (MRI). Thus, researchers were not able to explore any relationship between mTBI-related structural neuropathology and mTBI-related dysfunction, specifically cognitive impairment.