In this Blog category you will find articles about accidents that result in brain injuries and how to avoid them. Personal Injury suits and insurance claims may require the help of an attorney. A good lawyer can protect your rights under the law.

New Study Links Traumatic Brain Injury with Alzheimer’s

Brain Astrocytes

 

 

 

 

 

 

 

Researchers at Boston University School of Medicine have recently discovered that concussions can accelerate Alzheimer’s disease-related deterioration and cognitive decline in people who are already at risk of the disease.

Scans performed on 160 U.S. veterans of the Iraq and Afghanistan wars, some which had suffered traumatic brain injuries at least once during their military career while others never had a concussion, revealed that having a concussion was associated with deterioration in brain regions first to be affected in Alzheimer’s disease.

“Our results suggest that when combined with genetic factors, concussions may be associated with accelerated cortical thickness and memory decline in Alzheimer’s disease relevant areas,” said study co-author Jasmeet Hayes, PhD, assistant professor of psychiatry at BUSM and research psychologist at National Center for PTSD, VA Boston Healthcare System.

Three Tests to Reveal Alzheimer’s Disease

An important first step in developing a treatment plan for any disease is having a clear diagnosis. At this time, there are three tests to detect Alzheimer’s disease:

Biomarker Test, which measures and examines a protein in the cerebrospinal fluid that surrounds the spinal cord and bathes the brain for evidence of changes associated with Alzheimer’s

Brain Imaging with Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) scans, to record changes in the brain

Cognitive Assessment, using computer-based assessments to evaluate changes in thought, perception and memory

Study Shows Brain Changes Associated with Later Alzheimer’s in Young Age Group

The Boston University School of Medicine study with brain imaging showed that brain changes occurred in those with an average age of 32 years, suggesting that early detection of injury associated with late onset Alzheimer’s disease is possible. Early detection and medical intervention may prevent further mental decline or delay the onset, so it is important to document the occurrence and symptoms of a concussion, whether mild or severe.

“A lot of times when you get that Alzheimer’s diagnosis, the brain is far gone at that point and medication can only do so much,” said Jasmeet Hayes. “But if we try to intervene at an earlier point in people’s lives, that’s where the importance of this research is going to come in.”

Learn more about issues impacting safety, well-being, and justice at rizklaw.com. To schedule a confidential appointment to discuss a claim with an attorney, call (503) 245-5677 or email info@rizklaw.com.

By |January 15th, 2017|Brain Injury|

Laser Therapy Alternative to Drugs and Surgery for TBI

lllt

 

 

 

 

 

The development of low-level laser therapy (LLLT) for medical use, known today as photobiomodulation, began in 1967 as a therapy mainly for wound healing and pain relief. Since then its use has broadened to include diseases such as stroke, myocardial infarction, and degenerative or traumatic brain disorders.

Each year 1.4 million people in the U.S. suffer Traumatic Brain Injuries (TBIs). The World Health Organization (WHO) has projected that by 2020, road traffic accidents as a major cause of TBI will be the third leading cause of disease and disablement throughout the world.

Recent greater awareness of TBI after concussion from contact sports and after blast injury in military conflicts has caused researchers to look for a better way to treat this debilitating condition than drugs or surgery.

Low Level Laser Therapy Begins as an Accident

The discovery of lasers for medical use began by accident. In 1967, Endre Mester in lab experiments noticed the ability of the helium-neon (HeNe) laser, discovered in 1961, to increase hair growth and stimulate wound healing in mice. Since then, the use of low-powered lasers, as opposed to high-powered lasers that can destroy tissue, has steadily increased to areas of medical practice that require healing, prevention of tissue death, pain relief, and reduction of inflammation.

LLLT Use Expands to Include Brain Injuries

Low Level Laser Therapy (LLLT), now called photobiomodulation (PBM), was initially studied primarily for stimulation of wound healing and reduction of pain and inflammation in conditions such as tendonitis, neck pain, and carpal tunnel syndrome.

Margaret Naser and collaborators testing PBM in human subjects who had suffered TBI in the past discovered that, after treatment, those patients were better able to concentrate and remember events and experienced improved sleep, fewer headaches, and fewer post-traumatic stress disorder (PTSD) symptoms, and the effects were long-lasting. There is even the possibility that PBM could be used for improvement in memory and concentration in normal healthy people.

How Does Photobiomodulation Work?

Photobiomodulation brings oxygen to the area in a cell responsible for growth and repair. When applied to acupuncture points located on the scalp, it stimulates healing and repair in tissue that has been injured, is degenerating, or is at risk of dying.

PBM for brain disorders, whether it be an office or clinic based procedure or a home-use based device, may become one of the most important medical applications of light therapy in the coming

By |December 24th, 2016|Brain Injury|

Staying in the Game After Concussion Means Longer Recovery

football-concussion

 

 

 

 

 

A study conducted in May 2016 among various sports at the University of Florida, a National Collegiate Athletic Association (NCAA) Division 1 university, found that those who continue to play immediately after a concussion averaged an extra five days before being cleared to return to play compared to those who had stopped play immediately after a concussion.

Researchers analyzed information in the University of Florida Concussion Databank, which collects medical history, details of injury events and assessment data for student athletes. The study focused on 97 athletes, 75 of whom were men, who sustained a concussion during a game or practice between 2008 and 2015. The athletes played football, soccer, basketball, swimming, diving, volleyball and other sports, but the concussion recovery times were not broken down by individual sport.

There were other unaccounted for variables in the study. In many of the cases, the researchers could not tell how much longer a player had stayed in the game after suffering a concussion because the player did not immediately report symptoms or the initial injury had been coded as something other than concussion before the player reported head injury symptoms. Nevertheless, the study results provide evidence that changes in brain cells caused by concussion may also be compounded or prolonged by playing through a concussion and cause prolonged recovery.

“The brain is likely vulnerable to further physiologic and metabolic changes right after an injury – whether that be from sustaining more impacts or even from continued physical exertion,” said lead author Breton Asken, a neuropsychology graduate student in the University of Florida’s Clinical Psychology doctoral program. “Our findings indicate that immediately engaging your medical staff if you suspect you have sustained concussion will give you the best chance to return to your sport more quickly,” Asken advised athletes.

Being sidelined for extra days may resonate more with athletes than the risk of brain injury to their health, and getting back into the game as quickly as possible is practical for both coaches and athletes. Players are also encouraged to report symptoms in a teammate to help them get better faster.

By |November 24th, 2016|Brain Injury|

Nerve Cell Transplant Discovery Repairs Injured Brains

nerve-cells

 

 

 

 

 

 

 

Scientists at the Institute of Stem Cell Research at Helmhotz Zentrum Munchen in Germany have recently been able to restore function by transplanting embryonic nerve cells into traumatically injured brains. The grafted neurons, over the course of many weeks, integrated into brain circuits that normally never incorporate new neurons in the adult brain and became functional nerve cells.

Embryonic neurons transplanted into the damaged brain of mice formed connections with nearby nerve cells, restoring function. After four weeks, the transplanted cells became the type of cells normally seen in that area of the brain and were functional and responding to visual signals from the eyes.

Embryonic Nerve Cells Eliminate Need for Stem Cells

The institute has found that stem cell transplants from donors have been limited in their ability to regenerate damaged nerve cells. Building on research by Japanese scientist Professor Shinya Yamanaka in 2006, they have discovered that embryonic nerve cells have the ability to convert into stem cells, thus eliminating the need for stem cell donors.

The discovery provides new hope to victims of traumatic brain injury and stroke. With this research, we know that embryonic nerve cell transplants can reprogram cells in the brain. “I’m excited about this study,” said Sunil Gandhi of University of California, Irvine. This is evidence that the brain can accept the addition of new neurons, which normally doesn’t happen. That’s very exciting for its potential for cell-based repair for brain.”

There is some caution with the new approach, however. While the behavioral rehabilitation of stroke victims can be limited and frustrating, what if transplanted cells become cancerous, causing more harm than good?

Long Term Goal to Stimulate Brain to Produce Its Own Cells

The Institute of Stem Cell Research plans to “further develop the approach to activate endogenous cells in the brain towards the long-term goal of regenerating neurons from local sources of supporting cells, thus avoiding the need of transplantation,” said Professor Magdalena Botz, director of the Institute of Stem Cell Research at Helmholtz Zentrum Munchen.

By |October 29th, 2016|Brain Injury|

Traumatic Brain Injury Detection Helps Students Succeed

child-tbi

 

 

 

 

 

 

 

The Centers for Disease Control (CDC) estimates that more than 60,000 children and adolescents are hospitalized annually in the United States after sustaining moderate to severe brain injuries from motor vehicle crashes, falls, sports and physical abuse.

Children with Unidentified TBI Miss Special Ed Services

Damage from a TBI may be subtle and often goes undetected. If an injury occurred in infancy or before a child reaches school age, parents may not realize there could be a connection with the injury and learning and behavioral problems when the child enters school. When the information about an injury does not follow a child through his or her educational career, as frequently happens when a child moves from school-to-school, the child either does not receive special education services at all or receives services for a disability other than TBI.

Brain Check Survey Detects Hidden TBI

Because neither a parent nor doctor can tell the full extent of an injury at the time of the injury, school personnel must know how to look for subtle and longer-term effects on any student who has suffered a traumatic brain injury. In a case when there are symptoms but no known TBI, the school must be able to identify the injury to properly place the student in special education services.

Researchers Pat Sample and David Greene, both faculty in Colorado State University’s Department of Occupational Therapy, have developed a screening tool, called a Brain Check Survey, to detect a past TBI in school age children. Donna Detmar-Hanna, occupational therapist for the Poudre School District in Colorado reports that, to date, the Brain Check Survey has been used to screen around 10 to 12 students, and has been helpful in connecting past brain injury with present symptoms and behaviors.

Previously, a student needed to present an official documentation of a medical TBI diagnosis to be placed into special education with a TBI categorization. Now a few states will accept evidence of credible TBI history instead of medical diagnosis, which may be absent, and the results from Sample and Green’s Brain Check Survey can be offered as evidence of a past TBI.

Schools Best to Identify TBI and Follow Student Progress

The seriousness of a brain injury can best be determined by the effect it has on physical health, learning, behavior, and social development, and schools can watch these children for years and decades.

Schools need to:

By |October 16th, 2016|Brain Injury, Child Injury Accidents|

New Hope for Traumatic Brain Injury Patients

tbi-brain

 

 

 

 

 

 

A drug commonly used to treat depression and schizophrenia now shows promise in restoring memory to patients with traumatic brain syndrome.

Tetra Discovery (a pharmaceutical company in Boston), in association with the University of Miami Miller School of Medicine, Department of Neurological Surgery, and funded by the National Institutes of Health (NIH/NINDS), has found that a certain phosphodiesterase-4 inhibitor (PDE4B) has the ability to bring memory back to those suffering from the effects of a traumatic brain injury (TBI).

Learning and Memory Difficulties with TBI

Traumatic brain injury is caused by a violent blow or jolt to the head or body, with or without skull penetration, which causes mild to long-term dysfunction of brain cells. Nearly eight out of ten TBI survivors from a brain injury experience learning and memory difficulties months to years after a brain trauma.

According to the CDC (United States Centers for Disease Control and Prevention), approximately 1.5 million people in the U.S. suffer from a traumatic brain injury each year, and more than 5.3 million people live with disabilities caused by TBI. So far, the most successful treaments have been with either Ritalin or Aricept, but neither has been shown to improve memory.

Central Nervous System Chemical Shows Promise in Treating TBI

PDE4Bs, known to improve memory and wakefulness in central nervous system disorders such as clinical depression, anxiety disorders, schizophrenia, Parkinson’s disease, and Alzheimer’s disease, now shows ability to restore memory to those suffering from TBI.

Research studies have shown that brain trauma inhibits a protein in nerve cells that is critical for memory. Researchers have now found that treatment of traumatized brains of rats with a certain kind of PDE4B inhibitor significantly reverses TBI-induced memory loss. The goal of the researchers with these studies has been to restore the learning and memory performance of TBI animals to nearly non-injury levels.

Research to Continue with Human TBI Survivors

The joint research project is an example of collaboration between academic researchers studying animal models of brain injury and a biotech company with expertise in human clinical trials. The University of Miami plans to continue its collaboration with Tetra with a clinical trial using this therapeutic strategy with human TBI survivors.

By |October 9th, 2016|Brain Injury|

Can the Brain Re-Wire Itself after a Traumatic Brain Injury?

 

brain

 

 

 

 

 

 

 

Throughout life, the human body and brain are in a constant state of injury and repair. Substance abuse and lack of sleep and exercise decrease brain function, while physical and mental exercise, rest, and good nutrition build up and repair brain cells.

A traumatic brain injury (TBI), as shown on MRI, when severe can cause irreparable damage that leads to lifelong chronic disease. The effects of a TBI then becomes an ongoing problem that gets progressively worse, causing the injured brain to become less able to function physically, mentally, and socially, and may actually shrink, causing further difficulty. Following a TBI, an injured individual becomes less able to cope with and recover from the injury and is more susceptible to oncoming dementia or Alzheimer’s disease (“advanced aging”).

TBI Requires Ongoing Care

When severe, the effects of a traumatic brain injury requires a plan for future medical expenses, which includes part time care and attempted rehabilitation, sometimes followed by years of full time nursing home or nursing care. Faced with a lifetime of physical and mental disability, a victim of a TBI also must cope with denied long term care insurance coverage because of this prior injury, making monetary compensation for the injury essential.

Getting Necessary Compensation

If you have been in a car accident or other type of accident and think you may have sustained a brain injury, keep all medical records and document in a journal the effects of the injury on your daily life. To obtain just compensation for your injuries to cover costs of therapy and medical visits, loss of income, reduced quality of life, and the pain you have suffered you also need to talk to an injury attorney, who can calculate the damages (monetary compensation).

Brain injury claims are unique in that injury is often not obvious to others. Brain injury causes great psychological suffering that many people, including some doctors, just don’t understand. The right attorney will carefully evaluate your injury claim and probabilities of outcome to determine whether a settlement or personal injury lawsuit is the right option for you.

By |September 19th, 2016|Brain Injury|

Oregon Boat Safety for 2016

boat-52w3

Yes, I’m a lawyer, but in a former life I was a YMCA boating instructor, camp counselor and life guard. In that context safety was front and center. Sadly, I have seen safety take a back to recreation as children become young adults… until tragedy strikes.

Memorial Day weekend will be here in a few days so NOW is a great time to remind all my friends and clients that “an ounce of prevention is worth a pound of cure.” Keep in mind that most safety rules were enacted in response to serious injury. Here I focus on Oregon boating safety rules, precautions and insurance.

1. Oregon Boating Safety Certificate
All persons operating a boat of 10 horsepower or more must take an Oregon approved boating safety course and carry a boating safety card. It only costs $10! The course is $25.50. Here is the link to get a boating safety card which does not expire. (Note a boating safety card is not a boating license). See ORS 830.086.
https://www.oregon.gov/OSMB/boater-info/Pages/Motorized-Mandatory-Education.aspx

2. Drinking and Boating
Operating a boat while under the influence of any intoxicant is illegal. ORS 30.325. Also the owner of a boat is responsible for negligent operation of a boat just as an owner of an auto would be. ORS 30.330. Reckless operation of a boat is aslo prohibited in Oregon waters. ORS 30.315.

3. Boating Accidents
Oregon law requires boaters to promptly respond and report boating accidents. ORS 830.475. Also promptly report any boating accident to your boat insurer. If an accident happens, you must provide your NAME, ADDRESS, and BOAT ID # to all occupants of THE OTHER BOAT. In Oregon you must AID THOSE HURT by towing their boat to shore if needed and helping the injured get medical help. ORS 830.475. You must file a boat accident report for all boating accidents involving injury or property damage over $2k.

4. Boating Insurance
Your auto insurance probably only covers you when you are tailoring your boat. Purchase boating insurance to cover damage to your own boat as well as damage caused by your liability to others. Different types of boats (Ex. Wave runner v. sailboat v. motor boat). It’s best to purchase boating insurance from an agent who is knowledgeable about your boat and your exposures. Boating insurance, unlike Oregon auto insurance, does not require no fault medical insurance. Discuss the need for medical

Claim Value- Variable #1: YOU

This is the first post in my weekly blog series: Personal Injury Claim Value: Key Variables. During the past 25 years I have quantified claims big and small–as a large loss claims analyst (1996-2000), an insurance defense attorney (1990-1996) and since 2000 as a plaintiff personal injury attorney. I dedicate the series to my past clients, adversaries and their insurers whose now resolved disputes laid a pattern of lessons learned.

When it comes to personal injury claims ultimately there is really only one question: How much is my claim worth?”

The short, quick answer is a simple number. A number answer is understandable, plentiful at cocktail parties and easily generated from online injury calculators. The downside to quick injury claim quantification is huge– quick quantification is usually wrong.

In reality, claim value depends on several key variables. Notice the word “variable”. Just a tiny variable tweak can bring huge differences. Hold that thought. Now consider this. Variables constantly change and differ from place to place. Jurisdictions differ; each fact pattern has nuisance. Thus, this blog series is potentially infinite.

To make sense of this mess, each blog post focuses on one key variable only. I start with the most important variable of all—YOU. Your injury claim is all about you, or more accurately perceptions about you. You are NOT the person you are perceived as.

Perception of YOU

You are a trustworthy, hardworking person who was seriously injured by someone else’s mistake. But you won’t get a dime if the decision maker (however unreasonable) sees you as a cheater, slacker or injury faker.

In the personal injury claim context, “who you are perceived as” is more important than who you really are. Mindfulness of other lenses of perception is crucial to successful injury claim resolution.  The best you can, clear your mind of your point of view. Then ask yourself: “How might others view me, my injuries, my story my actions in the context of this injury claim?”  Your honest answers will lead toward better decisions and more effective testimony.

Decision makers spontaneously and unconsciously pre-judge based on individual life experience, attitudes and beliefs. During jury selection jurors will reveal personal experiences. Listening carefully will provide useful clues to juror paradigms.  To add a sour twist, some jurors consciously conceal true biases during jury selection. Your lawyer should ferret out potential jurors with life experiences that may cause prejudgment of you.

You will never know exactly how the decision maker perceives you. You

Fire Season & Head-on Crashes

FIRE and bellowing plumes of SMOKE make this summer particularly dangerous for motorists in Oregon and Washington State. Recognizing this danger, the Oregon Department of Transportation (ODOT) has recently closed several stretches of highway including:

1. Highway 26 ( at and around Warms Springs) ; and
2. 1-84 ( Pendleton to Ontario)

Highway 26 and I-84 are two of Oregon’s major significant east-west connecter. While necessary for safety, closures increase traffic on rural two- lane roadways not meant for high volume.

As an inevitable result, impatient drivers more frequently cross the yellow solid line, sometimes with fatal consequences. Meanwhile, plumes of smoke bellow across roadways obscuring visibility and distracting drivers. In central and western Oregon a haze blunts clear vision. And, during forest fire season motorists are more likely to use mobile devises, while driving.

One very serious cross over, head on collision occurred the morning of August 8, 2015 on Highway 97 just south of Bend. The crash seriously critically injured three persons including a 60 year old man from Sunriver. Police report that a Ford Explorer driven by a 19 year old crossed the center line. Pictures are shown below. The cause of the crash is under investigation.

hwy97.3hwy97.2