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.
Recent studies indicate that the harmful effects of a traumatic brain injury are more severe when there have been previous brain injuries, and the life altering damage from multiple TBIs can lead to suicide immediately after the event or even years later.
Study Links Multiple TBIs with Suicide
Craig Bryan, assistant professor of psychology at the University of Utah and associate director of the National Center for Veterans Studies, studying active-duty soldiers in Iraq in 2009, gathered data about their suicidal thoughts after returning to base with traumatic brain injuries. Bryan’s study, published in the medical journal JAMA Psychiatry in 2013, found that one in five patients, about 22 percent, who had experienced more than one traumatic brain injury (TBI) reported thoughts or preoccupation with suicide, compared to 6 percent of patients with only one TBI.
Soldiers in Bryan’s study with multiple TBIs were injured either in previous deployments or before enlistment, with some reporting as many as six sports related head injuries before enlisting. About 20 percent of service members sustained concussions during basic training. While deployed, some service members experienced as many as 15 TBIs, usually in an IED attack.
The Defense Department has estimated that 266,810 of the 1.6 million service members who served in Iraq and Afghanistan received a traumatic brain injury between 2000 and 2012. A 2008 Rand Corporation study estimated the number of TBIs much higher at 400,000. All five branches of the service have dealt with high suicide rates in recent years. In 2011, 303 active-duty service members killed themselves, and in 2012 the number increased to 349. Considering those statistics, a soldier is more likely to die from suicide than from war injuries.
Risk of Suicide Greater with Mild TBI
Bryan said his data and other studies also suggest that mild head injuries tend to be more likely to lead to suicidal thoughts than more severe ones, possibly because those who sustain a mild TBI don’t take time for a complete recovery. Although the military screens all at-risk service members for concussions, according to its protocol for handling TBI, those with mild head injuries return to the field within five days. Bryan concluded that the military needs to allow more time for recovery and do more to screen those with TBIs for personal risk factors for suicide.
Learn more about issues impacting safety, well-being, and justice at rizklaw.com. To
Data recently collected and reviewed from soldiers serving in Afghanistan and Iraq who sustained a traumatic brain injury reveals a correlation between Traumatic Brain Injury (TBI) and Post-traumatic Stress Disorder (PTSD).
In observance of March 2017 Brain Injury Awareness Month, researchers at the Uniformed Services University of the Health Sciences (USU) and the Defense and Veterans Brain Injury Center published this month in the journal Neurology results of their study “Epidemiology and Prognosis of mTBI in Returning Soldiers: A Cohort Study.”
Reviewing data from screenings for Traumatic Brain Injury (TBI) of about 1,500 soldiers returning from Afghanistan and Iraq between 2009 and 2014, the researchers found that nearly 50% of recently-deployed soldiers who sustained TBI reported at least one severe or very severe post-concussive symptom three months after returning home. Symptoms included headaches, sleep disturbances, forgetfulness, irritability, and trouble concentrating. Consistent with prior research, the study found that many of the soldiers with TBI also reported concurrent health issues such as post-traumatic stress.
Earlier Study First to Establish TBI PTSD Link
Findings published February 15, 2012 in the journal Biological Psychiatry following data collected from the 2012 Marine Resiliency Study (MRS), funded by the National Institutes of Health, US Department of Defense, and UCLA Brain Injury Research Center, showed the first evidence of a causal link between TBI and increased susceptibility to Post-traumatic Stress Disorder (PTSD). The researchers theorized that PTSD could be a reaction to the same event that caused the TBI. Findings from lab research in the study showed that brain injury effects a part of the brain called the Amygdala, leaving it in a more excitable state, in preparation for more trauma.
The main causes of TBI in the military are blasts, motor vehicle accidents, and gunshot wounds. Most soldiers in the study reported having experienced one or more TBI before their most recent deployment, either before joining the military or during an earlier deployment. The rate of PTSD after brain injury is much higher in veterans than civilians due to multiple and prolonged exposure to combat, and symptoms last much longer (18-24 months on average) after the TBI.
Comparing TBI with PTSD Symptoms
While TBI is a neurological disorder caused by trauma to the brain, PTSD is a mental disorder. In civilian life, anyone (child, adolescent, adult, or elderly) who is exposed to a life-threatening trauma such as from a
Objectively proving brain injury is the best and quickest way to win or settle a brain injury case. However, objective evidence of brain injury is not always present on MRI or CT scan, and patient symptoms alone such as confusion and memory loss may not be sufficient evidence of injury. A new technology added to traditional MRI called “Diffusion Tensor Imaging,” or MRI/DTI, is more sensitive to injury than traditional MRI and has helped to prove traumatic brain injury.
Juries tend to be sympathetic to brain injuries that can be objectively proved. However, imaging tools such as MRI and CT scans don’t always show evidence of brain injury, causing doctors to diagnose concussions more often based on the signs and symptoms a patient demonstrates, which insurance companies can often easily disprove.
Insurance companies, attempting to disprove an injury, will assume a patient is faking injuries or has psychological problems that pre-existed the accident. Grade school records, medical records from childhood, psychological and psychiatric records, and anything else through the years that insurance companies can obtain can be brought out as defense against litigation.
DTI Provides Better Evidence of TBI
DTI (Diffusion Tensor Imaging) is giving doctors objective evidence missing with traditional MRI. Invented 20 years ago, DTI is an imaging method that grew out of and is part of MRI. It is performed on a normal MRI machine with special “Diffusion Tensor Imaging” software that records damage in the white matter tracts inside the brain. White matter, like telegraph wires, connects different lobes of the brain. When white matter is injured, communication between areas of the brain it connects is decreased.
MRI/DTI tracks movement of water molecules within white matter fibers, and can detect interference with that movement. DTI can show injury to the white matter of the brain which cannot be seen on MRI, CT scan, PET scan, or SPECT, and can provide objective evidence of continued cognitive decline associated with confusion and memory loss.
A radiologist reading an MRI/DTI will perform a differential diagnosis to rule out other possible causes of an abnormality seen on DTI, such as an old stroke, a prior TBI, a prior brain surgery, prior infectious process such as encephalopathy, or history of MS. Other possible causes of abnormality on DTI could be a congenital process or degeneration due to advanced age of the patient. In those cases, DTI evidence would be
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 email@example.com.
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
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.
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.
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:
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.
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.