October 28, 2005, 8:35 am

Blood Test for TBI on the Horizon

Researchers at the University of Florida’s McKnight Brain Institute recently found that soon we may be able to detect the severity of a brain injury by testing blood samples soon after the injury occurs.

The theory goes something like this: when a TBI occurs, the injured brain cells release a chemical, and by measuring that chemical’s level in the bloodstream, we may be able to get an idea of how extensive the damage may be:

“The NF-H protein can be detected with a widely used screening method called ELISA, or enzyme-linked immunosorbent assay. Shaw developed antibodies that react positively to the presence of NF-H. Now he wants to apply the assay method to other proteins that may be potential biomarkers. He also wants to shorten the time to get results; with ELISA testing the process takes a couple of hours.”

By being able to perform blood tests for TBI, we may be on the brink of a new classification level for different kinds of brain injuries. There isn’t word yet on whether the blood test is effective for anoxic injuries or stroke.

Click here to read “UF experts discover process to better detect brain injury.”

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October 26, 2005, 8:22 am

Clooney's TBI Caused Excruciating Pain

Popular film star George Clooney has recently disclosed a year-long bout with a brain injury resulting from an accident he suffered during the filming of the movie “Syriana.”

Various news reports indicate the he tore the dura surrounding his spinal cord, which began leaking fluid. He also sustained what he calls a “bruised brain” which brought with it long, excruciating headaches that tormented him throughout the past year. Mr. Clooney eventually underwent several surgeries which remedied his pain, but he also reportedly experienced memory and cognitive problems, suggesting that the injury was more severe than the press may understand.

To me, this is a great example of how the media treats traumatic brain injury, and how culture works to obfuscate the real and lasting effects of a brain injury. Mr. Clooney has a career at stake, so it is probably in his financial interest to keep quiet about the more difficult effects his injury has caused. Did it give him problems memorizing his lines? Did he develop any depressive or anxiety-based symptoms? Is he prone to angry outbursts now? Over time, we may see a side to Mr. Clooney that reveals a more human aspect of brain injury, and hopefully those stories will propel greater advocacy. As it stands, I’m disappointed that his brain injury has been dismissed as a negligible bump on the head.

Click here to read about George Clooney’s Head Injury.

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October 25, 2005, 9:23 am

Fifth Inter Urban ABI Conference

This year, the Fifth Inter Urban ABI Conference was held in Peterborough, Ontario from October 19th to the 21st. The Inter Urban conference alternates annually with the ABI Network conference to create an informational forum for individuals who are living with a brain injury, their families, and rehabilitation professionals throughout Ontario. This year’s theme of “paddling the rapids” stressed the difficult course of life experienced by persons with a brain injury and their loved ones as they navigate the turbulent waters of recovery and rehabilitation. The conference was very well attended by TBI/ABI survivors, family members and professionals and was well worth the scenic drive from Toronto into the beautiful Peterborough hills, which were ablaze with Fall colour.

Top speakers like Doctors Mark Yvilsacker, Tim Feeney, Chanth Seyonne and Carolyn Lemsky addressed vital topics related to recovery and rehabilitation for children and adults. In addition to the rehabilitation professionals who spoke, there were compelling presentations by brain injury survivors Caron Gan and Rachel Oliver, including a film about a young woman with a brain injury living in her own home called “At Home With Laura.” I also attended several of the survivor presentations, including one which addressed dating.

NRIO presented three sessions. A presentation by Catherine Dodds, NRIO’s School Re-Entry Program Coordinator, focused on behavioural therapy in the classroom setting. Regan Brister, a survivor and Kellie Radley, OT, NRIO’s Clinical Director spoke about Regan’s injury, rehabilitation and recovery. I presented on Attempted Suicide as a Cause of Brain Injury.

Conferences like Inter Urban are vital to the brain injury community. By bringing people together and providing information from multiple perspectives, we’re able to strengthen the quality of treatment and outcomes over time.

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October 19, 2005, 9:39 am

TBI: Does It Cause More Damage the Suspected?

When it comes to brain injury, medicine is moving towards an increasingly integrated view of the brain. Nature Neuroscience has recently released some fascinating information regarding the scophttp://www.blogger.com/img/gl.quote.gif
insert blockquotee and affect of a traumatic brain injury. In the past, we’ve known that damage to a certain area of the brain yields certain results, but there may be much more damage that is “distributed” across the brain than previously thought.

Here’s a brief snippet from medicalnewstoday.com

“Clinicians who treat patients with stroke and other traumatic brain injury traditionally have looked to changes in patient behavior and abilities as indicators of the functions normally performed by the area impacted by the injury. However, because each brain area is connected to many others, some researchers have suggested a theory of distributed injury.”

How do these findings impact brain injury rehab? If the brain sustains damage globally, then it may be in everyone’s best interest to strengthen or stimulate all areas of the brain in order to maximize recovery potential.

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October 17, 2005, 9:19 am

Avoiding Brain Injury at Birth

As a TBI case manager, I’m exposed to a wide variety of cases where people have received brain injuries at various points in their lives. One of the most tragic form of brain injury can occur at birth, when babies are deprived of oxygen shortly before birth or during delivery. The condition is called hypoxic ischemic encephalopathy (HIE); it claims a high morbidity rate and an even higher rate of permanent disability.

Studies from the Neonatal Research Network of the National Institute of Child Health and Human Development have recently revealed that by “lowering an infants’ body temperature to about 92 degrees Fahrenheit within the first 6 hours of life reduces the chances of disability and death among full term infants who failed to receive enough oxygen or blood to the brain during birth.” It should be noted that at this point, this is currently an experimental procedure and should not be regarded as a regular course of treatment until the necessary studies have validated the research. Nevertheless, anything we can do to minimize anoxic TBIs at birth should become a matter of primary concern for neonatal healthcare professionals.

Click here to read “Cold Treatment Protects Against Infant Disability and Death from Oxygen Loss”

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October 10, 2005, 8:44 am

Falls a Major Cause of TBI Among Elderly

From 1996 to 1999, the CDC conducted a series of investigations into brain injury and discovered shocking numbers related to TBIs among the elderly. Here’s a brief snippet of the kinds of information uncovered:

“[The following pertains to California alone]Among those aged >85 years, three out of five hospitalizations resulted in a discharge to a residential facility with skilled nursing or to an in-home health service with outpatient rehabilitation services. Among older persons, an estimated annual average of 3,000 nonfatal falls results in hospitalizations for TBI at an estimated cost of $50 million.”

Let’s take a closer look at the sentences above. Of the 3,000 elderly TBIs each year, 1,800 were discharged to a nursing home or a house. NOT a brain injury rehab!

The elderly are considered such a high risk for TBIs for several factors, but unfortunately, we don’t hear much in the way of TBI prevention for the elderly. Should individuals taking certain medications receive training on how to minimize fall risk? Probably. Does this training occur? Rarely, if ever.

These “gaps” in prevention are precisely the sorts of things that future generations will be appalled by. If you work with a geriatric population, please become an advocate for safety prevention measures in your facility.

Click here to read the CDC’s report on “Non-Fatal TBIs from Falls“

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October 7, 2005, 9:16 am

Sports Concussion Assessment Tool

Earlier this month, medpagetoday.com posted an interesting article about a new assessment tool for the detection of concussions in athletes. Called DETECT (Display Enhanced Testing for Concussions and Mild Traumatic Brain System), the tool is supposed to be a 7-minute screen for injuries occuring immediately in the field.

While the idea of providing immediate assessment sounds like a step in the right direction, there are some inherent problems with a “quick-fix” mentality when it comes to brain injuries. If an athlete is even suspected of suffering a concussion during play, it is extremely important that the person does not continue engaging in the activity until a complete examination can be administered; the risks are simply too great for post-concussive syndrome.

Unfortunately, medical decisions like these occur far too often in athletics. We can only hope that with the right amount of prevention education, we can someday begin to see a drop in the numbers of TBI-related incidents occuring on the field.

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, 7:59 am

Neuroprosthetics–a future brain injury aid?

Many TBI survivors must endure a host of impairments as a result of lost motor skills. Poor balance, uneven coordination, and paralysis are only too-common amongst the brain injured population. Until recently, neuroprosthetics were considered a costly and high-risk alternative to re-acquiring motor skills.

Now, according the Nature magazine, researches are able to implant a device that allows users to control computer equipment by sensing brain waves from a scalp sensor–a totally non-invasive procedure.

Currently the technology exists, but it is still not precise. However, if it does finds its way into mainstream, it could dramatically change the quality of life for TBI and spinal cord injury survivors, offering them a level of independence they may have thought lost forever.

Click here to read “Non-invasive Neuroprosthetics”

Thanks, Mindhacks!

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October 4, 2005, 6:42 am

Aging and Brain Injury

At last week’s Southwest Conference on Disability, Dr. Gainer presented his talk “What Happens When Rehabilitation Ends,” which proved to be a timely offering. As we begin to see a greater influx of survivors on our already burdened system (consider all the head injuries from the Iraq war alone!), the issue of aging with a brain injury becomes a greater concern.

Among the attendees at the conference was a Vietnam-era veteran who shared with us the horror stories that involved his brain injury treatment in the late seventies. Today, almost thirty years post-injury, he’s come a long way, but he’s adopted rehabilitation as a way of life. “That’s the only way I’m going to get through this,” he shared with the audience.

In the upcoming weeks, look for more posts about aging and brain injury.

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