CDC Says 1.7 Million TBIs in the U.S. Annually

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Posted on 19th March 2010 by Gordon Johnson in Uncategorized

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The Centers for Disease Control and Prevention this week released the results of an extensive study of traumatic brain injury (TBI), and it offers a wealth of data – some of it disturbing. http://www.cdc.gov/media/pressrel/2010/r100317.htm There are an estimated 1.7 million deaths, hospitalizations, and emergency-department visits related to TBI in the United States each year, according to the CDC report released Wednesday.

“Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Death,” is based on data from 2002 to 2006 and identifies the leading causes of TBI and incidence by age, race, and gender. Here is other landmark information from that report: There were 52,000 TBI-related deaths and 275,000 hospitalizations annually. Almost 1.4 million, or 80 percent, of the people who sustained a TBI were treated and released from an emergency department.

That doesn’t bode well for these people, who may encounter long term, permanent problems stemming from their brain injury down the road.

The CDC report found that TBIs contribute to nearly a third or 30.5 percent of injury-related deaths in the United States.

Here are some other nuggets from the study:

  • •Children from birth to four years old; older adolescents aged 15 to 19 years,;and adults aged 65 years and older are most likely to sustain a TBI.
  • Falls are the leading cause of TBI (35.2 percent). Rates are highest for children from birth to four years and for adults aged 75 years and older.
  • Among all age groups, road-traffic injury is the second leading cause of TBI (17.3 percent) and results in the largest percentage of TBI-related deaths (31.8 percent).
  • In every age group, TBI rates are higher for males than for females.

“This report not only presents TBI numbers, it helps to show the impact of this injury nationwide,” Dr. Richard Hunt, director of CDC’s Division for Injury Response, said in a press release. “These data can help to impact the lives of millions of Americans as they serve as building blocks that guide TBI prevention strategies. They also help to identify research and education priorities and support the need for services among individuals at risk or living with a TBI.”

The CDC said it’s trying to create educational outreach initiatives to increase awareness and improve the prevention, recognition, and response to TBIs.

The CDC’s “Heads Up” educational initiatives have already been y adopted in emergency departments, doctor’s offices, playing fields, homes and schools. These initiatives provide information to health care providers, patients, school professionals, sports coaches, parents, teens, and youth on how to prevent, recognize, and manage TBIs. A free copy of the TBI report can be downloaded at http://www.cdc.gov/traumaticbraininjury/tbi_ed.html.

The problem with this type of epidemiological reporting is that it doesn’t go far enough.  What is needed is a comprehensive statement from the CDC as to how to best diagnose concussion (detailed investigation of amnesia,not just confusion) and to require that accident and fall cases get the same follow up that sport cases do.

Hammering Home the Seriousness of Concussions

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Posted on 10th March 2010 by Gordon Johnson in Uncategorized

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It’s always good for the American public to be made aware of the dangers of brain injury, and that a concussion is not “just” a concussion.” And that’s the message that’s being taught this month, which has been designated Brain Injury Awareness Month. http://www.healthnewsdigest.com/news/Family_Health_210/It_s_Not_Just_a_Concussion_-_It_s_a_Brain_Injury_printer.shtml

It’s never a bad idea, and can’t be stressed too often, that concussions do constitute brain injury. One physician pointed out that of the 1.4 million traumatic brain injuries (TBI) in the United States each year, 75 percent are usually concussions.

Public information about the danger of head injury and concussions doesn’t have to be dry and dull. The Mission Children’s Hospital has put together a clever nine-minute video for kids about why they need to wear helmets to protect against head injury.

http://www.youtube.com/watch?v=yr0YAoWe9XI

A demonstration of how a brain is bounced around in the skull when a head sustained a blow is done with jelly in glass bowl, and makes its point quite vividly.

Arizona Teen Dies From Brain Injury Sustained in Accident at 24-Hour Endurance Race

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Posted on 3rd March 2010 by Gordon Johnson in Uncategorized

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An 18-year-old youth was died Tuesday of brain trauma he sustained when he was hit by a car during a 24-hour endurance relay face this past weekend in Arizona. http://www.azcentral.com/community/phoenix/articles/2010/03/02/20100302brophy-teen-dies.html#

Robert Mayasich, a student at Brophy College Prep, passed away at St. Joseph’s Hospital and Medical Center three days after he was transported by air from Arizona 74 west of Lake Pleasant.

He had been part of a 12-man team in a race from Prescott to Tempe. But he wasn’t running his part of the race when he was hit by a Toyota Camry Solara.

Arizona public safety officials could release a report on Mayasich’s fatal accident by the end of the week.

Those who participate in the 24-hour race are encouraged to wear reflective safety gear, like headlamps and reflectors.

More Than 1,000 Disabled in N.J. Could Lose Benefits From Cash-Strapped Traumatic Brain Injury Fund

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Posted on 20th February 2010 by Gordon Johnson in Uncategorized

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Roughly 1,300 disabled people in New Jersey could lose treatment and services because of budget cuts impacting the state’s Traumatic Brain Injury Fund.
http://www.nj.com/news/index.ssf/2010/02/nj_assembly_committee_discuss.html

A New Jersey Assembly committee met Thursday to talk about possible ways to raise more money for the fund. In order to keep within the fund’s yearly $3.4 million budget, some officials have recommended that the fund only serve those who sustained a blow to the head, not those who suffered brain injury from a stroke, tumor or other type of trauma.

If that change were made, 60 percent of the 2,000 people who now get services from the program would be ineligible for it.

One of the solutions being considered is raising the 50-cent surcharge on car registrations that funds the program now.

Recipients who would be cut off from the Traumatic Brain Injury Fund are understandingly upset, as described in this well-done human interest story by The Star-Ledger of Newark, N.J.

http://www.nj.com/news/index.ssf/2010/02/state_brain_injury_fund.html

The story talks about the case of Michael Jankowsky of Toms River, who got stabbed in the heart trying to protect a friend 25 years ago. His brain didn’t get oxygen, and he suffered brain damage. He needs constant care, at age 45.

“He uses a wheelchair, slurs his speech, and struggles to concentrate,” The Ledger writes. “He has made progress over the past few years, his mother says, thanks to New Jersey’s Traumatic Brain Injury Fund, which paid for speech therapy and other treatments not covered by insurance.”

The story goes on, “That could end soon. The Brain Injury Fund is going broke, and the state wants to limit whom it helps to people whose brain damage came from a direct blow to the head.”

This is absurd. The issue is whether the brain is injured, not what mechanism of injury caused it. Some of the most serious of brain injuries don’t involve any blow to the head and as high as 50% of concussions do as well. See http://subtlebraininjury.com for more on the mechanical forces which cause brain injury.

Olympics Marred by Luger Death Before The Really Dangerous Sport Kicks Off, Snowboarding

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Posted on 16th February 2010 by Gordon Johnson in Uncategorized

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Observers feared that daredevil snowboarders might wind up dead at the Winter Olympics in Vancouver, pounding their skulls while attempting death-defying feats in the competition. But it was the luge sport that right out of the gate turned the games “into a gallows,” as one sportswriter out it.

And Olympic officials appeared more concerned about covering their asses than addressing the why of what happened.

This weekend there were many eloquent stories in the national press about the cowardice of the sports officials who blamed Nodar Kumaritashvili, the Georgian Luger killed at the Vancouver Olympics last week, for causing his own tragic death.

In its five-paragraph statement Friday, the International Luge Federation said that the Kumaritashvili came out of a curve and “did not compensate properly…there was no indication that the accident was caused by deficiencies in the track.”

http://www.vancouver2010.com/olympic-news/n/news/fil-statement-on-mens-luge-competition_274462nE.html

There was no mention of the fact that the steel pillar that the 21-year-old luger slammed his back into at racetrack speeds wasn’t padded, or that Olympic lugers were terrified of the track.

The New York Times did a Page One story Sunday on that topic, headlined “Fast and Risky, Sledding Track Drew Red Flags.”

http://www.nytimes.com/2010/02/14/sports/olympics/14track.html?ref=sports

Also on Sunday, The Times blasted the luge federation for its findings in a story headlined “Quick to Blame in Luge, and Showing No Shame.”

http://www.nytimes.com/2010/02/14/sports/olympics/14longman.html?hp

“Olympic officials treated the death of Nodar Kumaritashvili, the Georgian luge athlete, less as a tragedy than as an inconvenience,”
The Times wrote.

Back injuries aren’t the only thing to anticipate with these luge races. Last week a Romanian, Violeta Stramaturaru was knocked unconscious on Thursday and taken to a hospital after slamming into a wall several times.

http://www.nydailynews.com/sports/more_sports/winter_olympics_2010/2010/02/12/2010-02-12_luger_nodar_kumaritashvili_rushed_to_hospital.html?page=1#ixzz0fYFguzaH

Here’s the best summation we read of the tragedy over the weekend, by New York Daily News sports columnist Filip Bondy.

http://www.nydailynews.com/sports/more_sports/winter_olympics_2010/2010/02/13/2010-02-13_quit_playing_a_risky_game.html

“In the end, it wasn’t the halfpipe or the freestanding aerials that turned the Winter Olympic into a gallows,” he wrote Saturday. “It was as slippery-sloped luge track, designed by someone who didn’t know the sport and nurtured by a system that reward outrageous risk-taking.”

The New York Times Saturday said in a Page One story that the Georgian’s death “casts a pall” over the Winter games.

http://www.nytimes.com/2010/02/13/sports/olympics/13luge.html?hp

On the sports pages that same day, The Times noted that the Winter Olympics have “had ample adversity and controversy,” from too-little snow “and doping” scandals, “but genuine tragedy has been a rarity.
http://www.nytimes.com/2010/02/13/sports/olympics/13clarey.html?hp

Prompted by last week’s death, Olympics officials have taken steps to make the luge track safer. For example, they have moved the men’s start line farther down the track.

We’ll see if that helps – and hold our breath for when the supposedly really dangerous competition starts: snowboarding.

Study To Research Impact of Progesterone on TBI Patients

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Posted on 12th February 2010 by Gordon Johnson in Uncategorized

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Ironically, despite a strong recommendation from the authors of the Guidelines for the Management of Severe Traumatic Brain Injury that the use of steroids was NOT recommended for the treatment of severe traumatic brain injury, research in the area continues. The irony is that the Brain Trauma Foundation is supporting such research, despite the fact that they were the publishers of the Guidelines. The Guidelines were published in Journal of Neurotrauma, Volume 24, Supplement 1, 2007. http://www.braintrauma.org/site/PageServer?pagename=Guidelines

The latest guideline said this about steroids:

The majority of available evidence indicates that steroids do not improve outcome or lower ICP in severe TBI. There is strong evidence that steroids are deleterious; thus their use is not recommended for TBI.

Currently there is little enthusiasm for re-examing the use of existing formulations of steroids for treatment of patients with TBI. If new compounds with different mechanisms of action are discovered, further study may be justified.

I guess a lot has changed in less than three years. A nationwide study, named ProTECT, on the use of progesterone to treat moderate to severe brain injury will be conducted at 17 hospitals across the nation, it was announced Wednesday.
http://www.henryfordhealth.org/body.cfm?id=46335&action;=detail&ref;=1057 Progesterone also known is a steroid hormone which is part of the female reproductive cycle.

The study, funded by the National Institute of Neurological Diseases and Stroke, will track 1,100 patients nationally for at least three years. http://www.freep.com/article/20100210/BUSINESS06/100210029/1320/Hospitals-take-part-in-brain-injury-study

The goal of the research is to find out if the hormone progesterone can lessen the disability and death, that can stem from Traumatic Brain Injury, the leading cause of death and disability in those younger than 44 years old, according to the Brain Trauma Foundation.

Research with animals has found that progesterone may lessen brain damage resulting from TBI.

ProTECT is a double-bind study, and will evaluate patients with moderate to severe brain damage. The evaluation must take place within four hours of the injury, and enrolled patients will either be given a placebo or the progesterone intravenously.

The Food and Drug Administration is allowing hospitals to enroll patients without written consent because TBI patients may not be conscious or have the ability to make an informed decision right after their injury.

Four Detroit hospitals will take part in the study, namely Henry Ford Hospital, Detroit-Receiving Hospital, Sinai-Grace Hospital and Beaumont Hospital.

One of the last studies on the use of steroids for TBI was halted mid-trial because of hard evidence that it was doing more harm than good. We hope this one is monitored with extremely tight controls, with no vested stake in continuing the study if things start to go wrong.

Certain Brain Damage Can Impact Spirituality, Study Finds

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Posted on 11th February 2010 by Gordon Johnson in Uncategorized

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All that we are is in our brains. Heart break happens in the brain. Love happens in the brain. And yes, if you are “saved”, it is your brain that is saved. The brain is the home of the human soul. The study below is further confirmation.

A new study has found link between brain activity and spirituality by testing patients before and after they had surgery to remove brain tumors. http://www.sciencedaily.com/releases/2010/02/100210124757.htm

The study, published in the Feb. 11 issue of the journal Neuron, focused on the a personality trait, self-transcendence (ST), which is used
as a gauge of spiritual feeling and thinking in individuals. The characteristic is marked by a person feeling like he or she is a part of the larger universe.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WSS-4YC2GXT-5&_user=10&_coverDate=02%2F11%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view;=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5;=e4fb1257622032866d30264bf0a9b724

The research compared ST scores of patients before and after they had brain tumors removed, mapping their brain lesions after surgery.

The study determined that select damage to the left and right posterior parietal regions of the brain increased ST. That has lead researchers to believe that dysfunctional parietal neural activity may cause changed spiritual beliefs and actions.

Zackery Lystedt Brain Project To Be Announced at the Super Bowl, New York Times Reports

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Posted on 1st February 2010 by Gordon Johnson in Uncategorized

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The Zackery Lystedt Brain Project will be announced at the Super Bowl, The New York Times reported Sunday. http://www.nytimes.com/2010/01/31/sports/31concussions.html?ref=sports

The Lystedt initiative, lead by the Sarah Jane Brain Foundation and the American College of Sports Medicine, will push to convince more states to pass legislation protecting young sports players from concussions and their after effects.

Washington and Oregon enacted the first concussion-specific laws related to concussion protection for school athletes. The law that Washington passed is named after Zackery Lysedt, who sustained serous brain injury in 2006 playing football, according to The Times.

The Washington legislation has become a model for other states. The law requires that coaches be educated on concussions; that players be taken off the field immediately if it’s suspected they’ve sustained a concussion; and that a doctor must clear an athlete before he or she can return to play.

There could be as many as two dozen states that may pass laws related to concussions and youth sports, The Times says. Florida, New Jersey, New York and Massachusetts have bills in the works.

A House Judiciary Committee forum, the third one, will be held Monday, Feb. 1, in Houston to discuss brain injuries in football.

There have been two prior committee meetings, which discussed the poor treatment of concussions by the NFL. The league responded by adopting some new rules, including one that bans players suspected of having a concussion from returning to a game or practice.

Editor’s Note: You cannot tell the difference between a mild concussion and a serious concussion until you wait hours. While there is arguably a cost benefit analysis to returning the quarterback of an NFL team to the game, there is no cost to holding out a scholastic player from that game. This is especially true because there will is no guarantee of a sideline medical professional trained to clear the player. But as brain injury is a process not an event that takes a minimum of 24 hours to fully manifest itself, any return is risky. Sit the injured player and test them the next day, when you can give a sensitive test for amnesia. See http://www.youtube.com/profile?user=braininjuryattorney%22%3Ehttp://youtube.com/profile?user=braininjuryattorney%3C/a#p/u/11/dEWHgwRywtY

Veterans With PTSD Win Review of Their Rejected Benefit Claims

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Posted on 31st January 2010 by Gordon Johnson in Uncategorized

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Veterans of the wars in Iraq and Afghanistan, whose claims for benefits based on post-traumatic stress disorder (PTSD) were rejected, will have another chance to get relief. For the full story, see http://www.military.com/news/article/vets-with-ptsd-may-get-benefits-upgrade.html

The military has agreed to do an expedited review of the claims due to a judge’s order, which stemmed from a class-action lawsuit filed by seven combat veterans who were discharged for PTSD. Those vets claim they were illegally denied health care and other benefits that they were entitled to with their disability.

One of the original plaintiffs was ex-Army Sgt. Juan Perez, who suffers from PTSD and has problems with migraines and his eye resulting from a head injury he sustained during two tours in Iraq.

The Pentagon mandates that soldiers who leave the military due at least in part to PTSD must receive a disability rating of at least 50 percent to get full benefits, according to the National Veteran Legal Services Group.

But roughly 4,300 former soldiers earned ratings of less than 50 percent, so they were denied benefits. Those veterans will soon receive legal notice that they will be able to have an expedited review of their cases by the military, and that they can “opt in” to a class action lawsuit involving the matter.

The seven ex-soldiers who started the class action suit had disability ratings of 10 percent or less.

After the new review, former soldiers who get ratings of 30 percent or more will become eligible for benefits, according to The New York Times. http://www.nytimes.com/2010/01/26/us/26brfs-BENEFITSELIG_BRF.html
Those applications can be found at ptsdlawsuit.com.

Lawyers for the veterans expect that the reviews will result in ex-soldiers getting millions of dollars.
http://www.wsmv.com/news/22338751/detail.html

The higher disability rating will translate to lifelong monthly disability payments, and free health care for the veteran, his or her spouse and their minor children.

Why Doctors Shouldn’t Be Too Quick To Diagnose a Child With a Concussion Rather than Mild Traumatic Brain Injury

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Posted on 22nd January 2010 by Gordon Johnson in Uncategorized

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I have been fighting the labels and the distinctions about what you call the subtle damage to the mind as long as I have been an advocate. See my essay “Mind Damage” at http://tbilaw.com/essays.aaname.php Yet, according to new research, the labels make a huge difference in the perception of the severity of the injury.

According to this research, doctors apparently have to choose their words carefully when they’re talking to parents about their children’s head injuries. The study was published online this week by Pediatrics, the journal for the American Academy of Pediatrics. The study received a lot of play in the consumer press, with outlets such as The Los Angeles Times and UPI writing about it. See http://latimesblogs.latimes.com/booster_shots/2010/01/you-say-concussion-i-say-brain-injury-lets-call-the-whole-thing-serious.html

The bottom line of the research was that when a physician uses the term “concussion” rather than “mild traumatic brain injury,” parents don’t seem to believe that their child’s brain has really been damaged.

The Pediatrics article was headlined “My Child Doesn’t Have a Brain Injury, He Only Has a Concussion.” http://pediatrics.aappublications.org/cgi/content/abstract/peds.2008-2720v1

The research, conducted at McMaster Children’s Hospital in Canada by McMaster University, noted that doctors may choose to use “the concussion label” because it’s less alarming than the term mild brain injury. But the word “concussion” seems to imply to the parents that the injury is not serious and will have no long-term consequences for their child, the study found. Yet it’s known that’s not the case.

“Our study suggests that if a child is given a diagnosis of a concussion, the family is less likely to consider it an actual injury to the brain,” the study’s lead author, Carol DeMatteo, said in a press release on the research. “These children may be sent back to school or allowed to return to activity sooner, and maybe sooner than they should. This just puts them at greater risk for a second injury, poor school performance, and wondering what is wrong with them.”

Children diagnosed with a concussion were released earlier from the hospital, and returned to school quicker, according to the study. Yet it’s known that concussions can have serious after effects, including depression, memory issues and headaches. And returning to former activities, such as sports, before the brain damage of a concussion has healed can lead to dire health problems.

The concussion diagnosis was “significantly more likely” when the computed-tomography results were normal and the child had lost consciousness, according to the study.

The takeaway has to be that physicians should not be too quick to label a child as having a concussion, even if it is a less worrisome term than mile TBI.
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