Much-Needed Update Of Guidelines To Determine Brain Death Are Released

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Posted on 7th June 2010 by Gordon Johnson in Uncategorized

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There’s lots of injustice in this world, and declaring somone brain dead who isn’t would be high on the top of the list of such tragedies. 

 That’s why I think it’s a good idea that new guidelines for determining if a patient is brain dead have just been issued.  

Essentially saying it wants to take the guesswork out of the process, the American Academy of Neurology Monday released those new guidelines — the first update in 15 years. 

http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2010/06/07/experts-revise-guidelines-for-determining-brain-death.html

 The new guides tell physicians to do a extensive evaluation of a patient, with a check list of about 25 tests that must be performed and specific criteria that must be met.

The new guidelines were co-written by Dr. Panayiotis Varelas, director of the Neuro-Intensive Care Service at the Henry Ford Hospital in Detroit.

The U.S. Uniform Determination of Death Act does define when death takes place: When a person permanently stops breathing; the heart stops beating; and all brain functions, including those in the stem, stop.

The problem is that doctors differently determine who meets those criteria.

A 2008 study that included 41 of the country’s top hospitals, done by Varelas, found a lot of variability in how doctors and hospitals judged who fit the criteria. 

 Under the revised guidelines, the three signs of brain death are coma with a known cause; abscence of brain stem reflexes and the permanent cessation of breathing.  

Being in a vegetative state does not equate to being brain dead, according to the new rules.

Brain death is caused by severe traumatic brain injury, stroke or oxygen deprivation following cardiac arrest.         

Should Baseball Pitchers Wear Helmets?: Debate Renewed After Cleveland Pitcher Gets Beaned

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Posted on 3rd June 2010 by Gordon Johnson in Uncategorized

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 It hasn’t even been a week since New York Yankee slugger Alex Rodriguez hit Cleveland Indians pitcher David Huff in the head with a line drive. But Huff seems to have emerged magically uninjured by that heart-stopping accident.

http://www.nytimes.com/2010/05/30/sports/baseball/30yankees.html?ref=sports

 Huff, who had to be carried out of Yankee Stadium on a stretcher after getting beaned May 29, is back playing ball. The pitcher, who never lost consciousness after A-Rod’s hit struck him, didn’t sustain a concussion, or get so much as a headache, from being hit. His CT scan came back negative.

 http://bats.blogs.nytimes.com/2010/05/30/day-after-being-hit-in-head-huff-is-feeling-good/

 The evening of the day he was hit, Huff tweeted, “Everything is good. Was a little scary, but I’m out of the hospital and with my family.”

http://www.cleveland.com/tribe/index.ssf/2010/05/cleveland_indians_left-hander.html

 That’s all pretty remarkable, in that Rodriguez hit the ball with such force that it after it struck Huff’s head it flew and landed roughly 275 feet from home plate.

http://sports.yahoo.com/mlb/blog/big_league_stew/post/He-s-OK-folks-Indians-David-Huff-takes-A-Rod-?urn=mlb,244510

 Although the Huff case had a happy ending, the scary incident has some sports writer bringing up a question that’s been debated in baseball: Should pitchers be required to wear helmets for protection, like catchers?

 The knee-jerk reaction might be to say yes, pitchers should don helmets. After all, they face hardballs shooting back at race car-like speeds, more than 90 mph.

 And some players who have been hit in the head like Huff didn’t fare as well as him. The Cleveland Indians seem to be particularly jinxed. In 1920 Cleveland Indians shortstop Ray Chapman was killed by a pitched ball. And Indians pitcher Herb Score’s promising career ended when he was hit in the face with a line drive in 1957.

 But how far do you go to eliminate risk in sports? By their very nature, sports involve all kind of risks. You can’t eliminate them all.

 And if you believe baseball pitchers should wear helmets, then it follows that you would want to mandate that basketball players wear helmets, as well. In a recent week there were two concussions in just one basketball game. Basketball has a much higher frequency of concussions than baseball, except when it comes to batting.

 That said, the biggest risk of severe brain injury in baseball is not a pitcher taking a line drive in the head. It’s two outfielders going after the same ball and then colliding at a very high speed, head on head. Each year, some player dies as the result of such a collision.

 My answer to making baseball safer for pitchers isn’t a helmet, but rather a ban on aluminum bats. A player can swing an aluminum bat faster than a wooden bat, accelerating the speed the ball comes off the bat – and at the pitcher. That’s why for at least a decade the use of aluminum bats has been a controversial issue.

 Back in 2000, ESPN Magazine did a story headlined “Bat Controversy Lingers Over NCAA.”  In part, that article described how player stats soared as “hot” aluminum bats became more prevalent in the game. In the College World Series championship, from 1994 to 1998 there were 105 runs scored, versus only 33 in 1989 to 1993.  

http://espn.go.com/gen/s/2000/0329/453294.html

 Last year a Montana jury awarded a family $850,000 for the death of their son, who was killed in a 2003 baseball game where aluminum bats were used. The jury found that Louisville Slugger didn’t properly warn people about the potential dangers of the bat.

http://www.roundupnews.com/sports/aluminum-bats-still-safe-despite-lawsuit-against-bat-maker-1.861272

 But even that jury award didn’t convince people like New Mexico State University baseball coach Ricky Ward that aluminum bats were unsafe. In an interview, Ward said that deaths from batted baseballs were very uncommon.

 Ward suggested that instead of worrying about the aluminum bat, that the specifications on baseballs themselves be changed.

 That’s a new answer to an old problem, but we don’t know if it would work.

 

The Difference Between Life And Death: Bret Michaels’ And Gary Coleman’s Brain Hemorrhages

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Posted on 2nd June 2010 by Gordon Johnson in Uncategorized

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The New York Daily News Wednesday posed a question that may have crossed many people’s minds: Why did former child star Gary Coleman die last week of a brain hemorrhage, while rocker Bret Michaels lived?

http://www.nydailynews.com/lifestyle/health/2010/06/02/2010-06-02_brain_injuries_like_the_ones_suffered_by_bret_michaels_and_gary_coleman_can_have.html

Coleman, who had a lifelong history of health problems, suffered an intracranial brain hemorrhage when he slipped and fell in his Utah home last Wednesday after undergoing his usual dialysis treatment. Only 42 years old, Coleman went into a coma in the hospital on Thursday, and his family ended his life support on Friday.

Michaels, on the other hand, was at his Arizona home when he suddenly felt an incredible pain in his head. His wife rushed the singer to the hospital, where he was diagnosed with a subarachnoid brain hemorrhage. After some shakey moments, 47-year-old Michaels pulled through, and appeared on the finale of “Celebrity Apprentice,” which he won.

Reporter Rosemary Black explains the difference between the two brain hemorrhages. An intracranial hemorrhage takes place inside the brain, while a subarachnoid hemorrhage is bleeding into the lining around the brain.

Black interviewed physicians who said that the location of brain hemorrhage will determine if it will kill or not, if it will disable a patient in some way, or if they will fully recover. Of course, that’s just common sense: If the part of your brain that controls your breathing is damaged,  let’s face it, it’s unlikely you’re going to have a good outcome. 

One doctor added that Coleman’s poor health, he had two kidney transplants during his life and was on dialysis, likely made his prognosis grim after his brain injury. 

But then Michaels wasn’t a particularly well man. He had just had his appendix removed and he was a lifelong diabetic. And I believe that Michaels’ physician is jumping the gun by telling the press that the singer has fully recovered, that he is part of the small group of people — only 20 percent — who bounce back like new from this type of brain hemorrhage. 

I have written extensively on my blog, http://subtlebraininjury.com/, about apparent full recovery brain injury. Problems can develop later on with people who have sustained brain injury and appear to be back to normal. For example, those who have jobs that require their minds to have a high processing speed may find it harder to claim “full recovery” than those with less taxing jobs.  

And in a recent interview Michaels himself said, “I’m just not back to where I want to be just yet.” http://www.popeater.com/2010/06/04/bret-michaels-health-american-idol/?ncid=webmaildl2

 He performed Memorial Day weekend, and in the interview said, “On stage, normally, I go completely insane and kick ass. This time, I gave 100 percent of my 75 percent.” 

 

 

 

 

 

 

 

 

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