January 31, 2006, 9:06 am

Bob Woodruff's Brain: TBI Diagnosis?

From all the information gathered from recent news bits about ABC reporter Bob Woodruff, it appears he may have suffered some degree of traumatic brain injury. Consider the following statements used in media reports:

–”[Woodruff] used some “colorful language” before losing consciousness.”
–”this is not going to be a sprint, it’s going to be a marathon”
–”He responded to stimuli to his hands and feet.”

What’s interesting is what the press is not saying. There aren’t too many specifics about Mr. Woodruff’s head injury because of an unwritten rule of TBI: they can destroy a career. Even with a mild brain injury, we could see a very different Bob Woodruff on the news, but it’s too early to speculate about his outcome.

At this point, we can only hope that Mr. Woodruff’s has a healthy recovery, and that his terrible misfortune can turn into a vehicle for greater awareness of TBI and all the social issues that plague head injury survivors.

Click here to find out the latest reports on Mr. Woodruff and his cameraman Doug Vogt.

Link to this post

January 23, 2006, 2:14 pm

NY Times: One Soldier's Struggle With TBI

This past Sunday’s edition of the New York Times featured a moving account of Jason Poole, a 23 year-old Marine who sustained a traumatic brain injury in Iraq:

“…those who know Corporal Poole say his personality - gregarious, kind and funny - has remained intact. Wounded on patrol near the Syrian border on June 30, 2004, he considers himself lucky to be alive. So do his doctors. “Basically I want to get my life back,” he said. “I’m really trying.”

But he knows the life ahead of him is unlikely to match the one he had planned, in which he was going to attend college and become a teacher, get married and have children. Now, he hopes to volunteer in a school. His girlfriend from before he went to war is now just a friend. Before he left, they had agreed they might talk about getting married when he got back.

“But I didn’t come back,” he said.”

The article puts a human face on one soldier’s TBI, but it also acts as a strong piece of journalism. As most of us working with TBIs already know, survival rates for severe injuries continue to rise–but the support systems in place aren’t keeping up. The New York Times estimates that TBIs from the Iraq War alone will cost the government $14 billion dollars over the next twenty years. The crisis of care for TBI survivors is starting to get some notice. Now hopefully this notice will entice legislators to make the much-needed reforms to our healthcare system.

Click here to read “Struggling Back from War“

Link to this post

January 20, 2006, 10:18 am

Miner McCloy Emerging from Coma

Amid funerals and wakes from the recent mining tragedy in West Virgina, a small ray of hope shines through for Randy McCloy’s family. McCloy was the only person to survive the disaster, and is reported to be emerging from his coma, but there are some interesting details:

“With great hope, we announce that Randy McCloy is awakening from his coma,” said Dr. Julian Bailes, chairman of neurosurgery at the hospital.

But doctors cautioned that it could be weeks or months before they will know the extent of neurological damage suffered by Mr. McCloy, a slight 26-year-old nicknamed Skinny, the youngest of the miners trapped after the explosion.

“We must emphasize that he has a very long way to go,” Dr. Bailes said.

Mr. McCloy, of Simpson, W.Va., may be the longest known survivor of carbon monoxide poisoning, Dr. Bailes said. “So we’re in many ways in uncharted territory in terms of predicting his recovery, but we remain cautiously optimistic.”

In some ways, McCloy’s case is reflective of our modern predicament. Thanks to strides in technology and healthcare, people are surving injuries that would have killed them a decade ago. McCloy seems to have survived unprecedented carbon monoxide levels. With this remarkable recovery comes a great degree of uncertainty–nobody really knows how McCloy will be affected by his injury, and whether those effects will taper off or increase in the following years.

Click here to read more about Miner McCloy

Link to this post

January 19, 2006, 8:55 am

Cerebral Amyloid Angiopathy and Ariel Sharon

Prime Minister Ariel Sharon may have a delicate condition called cerebral amyloid angiopathy (CAA) that makes him particularly prone to strokes. While the condition sounds grim, aging brains often develop CAA. Medpage Today provides an excellent overview of CAA and its effects:

“Cerebral amyloid angiopathy is a silent disease in which diagnosis is made by “P*2 MRI that can detect microhemorrhage,” said Dr. Felberg. “But the only way to absolutely confirm the diagnosis is with a brain biopsy.”

In most cases the MRI scan is follow-up to CT imaging that is “done in the acute setting to differentiate ischemic stroke from hemorrhagic stroke,” Dr. Felberg said. “This is usually done in the emergency room.”

Continue reading about CAA

Link to this post

January 17, 2006, 10:30 am

Cutting Edge: Brain Injury and Transplants

Don’t worry; it isn’t what you think. While we’re a long way off from transplanting a brain, science is exploring an exciting new transplant procedure that could make a major difference in the world of brain injury. The Journal of Neuroscience reported:

“Increasing research, however, now points to new strategies that may eventually improve the future of these patients. Techniques that may hold promise for traumatic brain injury (TBI) include the use of special cell transplants. Specifically, recent animal studies provide evidence that cell transplant strategies may promote the repair of an injured brain and help restore lost abilities.”

Click here to read more about Brain Injury and Transplants.

Link to this post

January 16, 2006, 8:53 am

Sharon and Coma States

It’s interesting to watch the press parallel what happens in ICU units every day. A person in a coma is so still that any small change is widely reported. When Ariel Sharon moves his left hand, it makes headlines across the world; when a family member in a coma moves a limb, it sets off a spree of phone calls.

Doctors are often quick to point out that such movements from the comatose are often involuntary and can occur regularly, so the excitement some people feel over seeing motion from the comatose is often derailed. The truth is that neuroscientifically, we know very little about comas and their relationship to consciousness, so, more than anything, a comatose person is the medical embodiment of mystery and enigma.

We do know that as a coma continues, the level of impairment tends to magnify. Now that Ariel Sharon has been in a coma almost two weeks, Israel isn’t expecting him to return to his job for at least several months. Sharon’s coma has cast a cloud of uncertainty over world politics, and in a literal sense, thousands of other families must find their way through the same cloud that hovers near their comatose kin.

Link to this post

January 11, 2006, 8:58 am

Ask the Doctor: Recovery from Brain Cancer

Question:
I am female who was diagnosed with brain cancer (Gliobastoma Multiforme right temporal lobe)in 1995. I underwent a craniotomy, chemotherapy, and experienced ‘more than usual’ radiation to the area of my temporal lobe. How can I improve memory, concentration logic reading and cognitive skills?

Answer:
Thank you for your e-mail contact to Ask the Doctor. It appears that you have done well in your recovery and would benefit from some specific cognitive rehabilitation to focus on the issues which confront you. Have you had a neuropsychological evaluation to identify the specific problem areas as well as the areas of strength.? This type of evaluation would be helpful in determining the type of cognitive rehabilitation which will help you remediate the problem areas. Usually, cognitive rehabilitation occurs through Occupational or Speech Therapy or with specially trained educators. For some people, computer based cognitive retraining is very helpful.

Are you currently involved with your local Brain Injury Association in BC? The association usually can help you find a neuropsychologist who specializes in brain injury as well as identify programs and specialists in your community. The Ontario Brain Injury Association maintains an excellent web site with resources. The internet has many other brain injury resources which will be of assistance to you. You might to try biausa.org, the U.S. brain injury association, and look at the resource materials they offer.

I encourage you to continue your efforts to find help to address your cognitive problems. It sounds like you are motivated to achieve success which is critical. Please let us know if we can be of further help.

Sincerely,

Rolf B. Gainer, Ph.D., Diplomate, ABDA

Link to this post

January 9, 2006, 10:03 am

Miner Gets Mild TBI Diagnosis, Remains in Coma

ABC recently reported that lone surviving miner Randall McCloy has sustained a mild traumatic brain injury as a result of oxygen deprivation in last week’s mining disaster that claimed many lives.

So far, McCloy is still in a comatose state, but he is responding to stimuli and he is breathing without the help of a ventilator–both great signs that he is progressing well in his recovery.

Comas are one of the most confusing and distressing events to family and friends, because there’s often a great degree of uncertainty involved. Doctors don’t want to give too much information for fear of creating false hope, but they also don’t want to frustrate loved ones with lack of information. It’s a perpetual state of “let’s wait and see” than can sometimes become maddening the longer the coma lasts.

For more information about comas, read:
The Coma Recovery Association’s Articles on Comas.

Link to this post

January 5, 2006, 10:10 am

The Global Impact of Brain Injury

Two top stories in the news involve brain injury this week…

In America, Randy McCloy, the only surviving miner from West Virginia’s terrible coal mining accident, is alive but in critical condition following an anoxic injury that has affected his brain as well as other organs. Last night, his physician, Dr. Larry Roberts spoke with Larry King about the serious nature of McCloy’s injuries:

“I think what we’re most worried about is his brain recovery. Anybody who suffers what we call an anoxic brain injury, inadequate oxygen to the brain can develop long term disability from that. But, having said that, there are — there is an opportunity obviously for recovery and even this evening there has been some glimmer of improvement in his neurologic exam, so we can only hope for the best at this point.”

Across the globe, Israel’s Prime Minister, Ariel Sharon has sustained a serious brain injury due to stroke, which had led to bleeding in his brain. At this point, it’s too early to determine what sort of outcome lies ahead for Mr. Sharon, but one thing is certain: one small brain injury has caused a tidal wave of disruption in Middle East politics.

We tend to think of catastrophic injuries such as TBI as isolated events, but these two stories illustrate how truly interdependent we are, and how our own world is in part shaped by the injuries that befall us. While horribly unfortunate, perhaps these two seemingly unrelated injuries will spark renewed fervor for TBI research and treatment.

Link to this post

, 8:32 am

Teaching Kids about TBI

When a family member gets a brain injury, it’s often a confusing and disorienting experience for all the adult members. It can be extremely difficult for an adult to try to communicate the facts about a brain injury to a child, so thankfully, there are several guides available that can facilitate that process.

Neuroscience for Kids is a great starting point on the internet that helps children understand the brain and its processes. It is well-organized and comes with various experiments and activities that kids can enjoy.

There are also children’s books that deal with the topic of brain injury, available in both English and Spanish, as well as books about TBIs that affect children.

NASA’s Neurolab Mission is also a great resource that places focus on research and developments in the field of neuroscience, so that kids understand that brain injury treatment is a relatively new field, and there is still much to learn.

Geared towards older children and teens, the University of Wisconsin’s Why Files often feature great tidbits regarding neurology and neuroscience. And there’s also PBS’s great Probe the Brain site which encourages a virtual exploration of the brain through a slick little shockwave program.

For more links that help kids understand the brain and TBI, visit:
The Brain Exchange Mentorship Network

Link to this post