March 31, 2009, 7:17 am

Things to do if someone has suffered a head injury, as published in CNN health:

1. Be vigilant

Keep an eye on someone who has hit his head, even if the person never lost consciousness. “A lot of folks are still under the assumption that as long as you’re not knocked out, you’re OK, and that’s not true,” Ayotte says.

2. Look for dizziness, vomiting, headache and confusion

If the injured person has these signs, take him or her to an emergency room, says Dr. Jam Ghajar, clinical professor of neurological surgery at Weill Cornell Medical College in New York, and president of the Brain Trauma Foundation.

3. Look for changes in symptoms and behavior

Any sudden change, such as Morgan’s headache going from mild to severe in minutes, means the person needs medical attention. For example, Ghajar says, if a person gets suddenly sleepy in the first 12 hours after a hit, it may mean the parts of the brain responsible for staying awake are experiencing pressure from a bleed.

4. Be especially wary if someone a) has been drinking alcohol, b) is on blood thinners, c) is elderly or d) is a young athlete

It’s tough to distinguish brain-injured behavior from drunken behavior, so when in doubt, take the person to the hospital, Ghajar says. Also, blood thinners can turn a mild bleed into a major bleed, so be especially vigilant if the injured person is taking blood thinners such as warfarin.

He also warns people to be extra vigilant when an elderly person hits his or her head. The Centers for Disease Control and Prevention has information on traumatic brain injury and senior citizens. The CDC also has information on concussions in young athletes.

5. Go to a certified trauma center if you can

The American College of Surgeons has a list of certified trauma facilities; a hospital that’s not a trauma center may not have a neurosurgeon on call. You can also look on this map from the American Trauma Society. Find your state, select trauma centers, update the map, and you can find information about trauma centers in your area.

Click here to read the full article in CNN Health

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March 30, 2009, 10:08 am

Natasha’s Accident is Saving Lives by Increasing Brain Injury Awareness

Natasha Richardson’s accident and death has already saved one life. The parents of a 7 year old Morgan Mc Cracken were watching TV and learned about Richardson’s tragic death, which spurred them to action. Their daughter, Morgan, had been hit on the head while playing baseball just two days earlier, and appeared to be doing okay. Richardson’s accident made them stop and re-evaluate the situation.

When they went up to say good night to Morgan that night, she was complaining of a headache, and because of what they had learned about Natasha they called the pediatrician immediately. The McCrackens then took Morgan to the emergency room – from there she was taken via helicopter to Rainbow Babies and Children’s Hospital. It was there that the McCracken’s learned the dreadful news, their daughter had the same injury as Richardson: an epidural hematoma.

Thanks to the awareness Richardson’s death has wrought, this little girl is now at home and doing fine.

Click here to read the full article in CNN Health

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, 7:42 am

Expanding on "Keeping Our Heads"

Today, the New York Times ran my op-ed, “Keeping Our Heads,” which I wrote in response to Natasha Richardson’s death. I wrote the article in order to highlight the terrible gaps in our healthcare system that don’t appropriately address brain injury, but I feel that it’s necessary to clarify a couple of matters:

1) I wrote “According to a 2008 list put together by the American Academy of Certified Brain Injury Specialists, there isn’t a single certified brain injury specialist (CBIS) working on America’s ski slopes.” While this is indeed a fact, it warrants a closer look. Most CBISs work in the brain injury services industry, and the certification is primarily intended to further educate those how to respond to people with brain injury AFTER the injury is happened. It just so happens, that during this education, you also develop a great sense of what a brain injury is, and how to spot one. I certainly don’t want to offer CBIS up as a bandage to the problem at large–which is that there is not a standardized response in civilian America (as opposed to military America). In fact, I encourage ACBIS to create a special “responders” certification that more appropriately fits this need.

2) In the editing process, some things were removed that I would have liked to keep. Here’s the paragraph that I think added the right historical context to the article:

“In November 2007, over 100 brain injury professionals rallied in Washington, D.C. in response to the growing number of Iraq War service members returning with brain injury. They identified 20 major barriers to adequate brain injury care and recommended appropriate responses… Since the release of the Barriers and Recommendations report (disclaimer: I edited the report), the Department of Defense has increased its funding allocations to brain injury research.”

While these were two points I wish could’ve been included in the final edit, I believe most readers will understand the spirit of the op-ed as a call to action for better brain injury care and services for all Americans.

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March 25, 2009, 11:16 am

Music Helps

Brain Injured patients having difficulty with attention span may benefit from listening to some of their favorite tunes, reports MedPage Today. A recent study conducted by David Soto, M.D. or Imperial College London and colleagues found that “patients have better visual awareness when completing tasks while listening to music of their choice compared with unpreferred music or silence.” The researchers said that using music was affective even in chronic patients, and that “positive emotional responses and optimum arousal induced by pleasant music listening may aid the engagement of the neuroplastic systems that support flexible attention control.” Medpage Today reports:

“We speculate that pleasant music may lead to optimal, rather than maximal, levels of arousal, and this can reduce neglect, whereas unpreferred music may increase extinction by over arousing patients,” the researchers said.

The study also found consistent evidence for the effects of positive emotion. One of the three patients had a higher positive effect response relative to the other patients, suggesting that the “strength of the positive effect response may modulate improvements in visual neglect.”

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Click here to read the full article

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March 18, 2009, 9:02 am

Natasha Richardson TBI Promotes Prevention

In the wake of the horrible news about actress Natasha Richardson’s TBI, the NY Times’ Liz Robbins has written a snapshot account of brain injury prevention on the slopes:

“Helmets, once rarely seen on recreational skiers, are becoming increasingly popular. According to the National Ski Areas Association, 43 percent of all skiers and snowboarders surveyed in the United States wore helmets in the 2007-2008 season. That is up from 25 percent in 2002-2003, the association says.

Even so, the rate of accidental deaths on the slopes — there were 53 recorded last season, 44 from skiing accidents and 9 from snowboarding — has not changed much.”

Read more here: http://snipurl.com/e2jtz

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March 17, 2009, 1:03 pm

New Help for Head Trauma Victims

A study of mice at Georgetown University Medical Center shows that a new class of Alzheimer’s disease drugs may prevent long-term damage from traumatic brain injury. The drugs are designed to target plaque that accumulates in the brains of people with Alzheimer’s disease.

Why would this help in brain injury? Because “abnormal amounts of amyloid plaque have been found during an autopsy in about a third of brain injury victims, some of whom were children who would ordinarily never have had these deposits,” Mark Burns, a neuroscientist and assistant professor at Georgetown and the study’s lead author, said in a university news release. “Remarkably, these deposits occur in less than one day after injury.”

Those suffering from a brain injury have a 400 percent increased risk of developing Alzhiemer’s – According to Burns, one reason the study found may be due to the fact that “the same pathways activated chronically in Alzheimer’s disease are activated acutely in traumatic brain injury and that they appear to play a very important role in secondary injury.”

Click here to read the full article

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March 5, 2009, 4:04 pm

Veterans with Brain Injuries

USA Today reports that pentagon officials estimate that there are approximately 360,000 Iraq and Afghanistan veterans suffering from brain injuries. “Among them are 45,000 to 90,000 veterans whose symptoms persist and warrant specialized care. “

The estimates are based on military health-screening programs that are now mandated for our troops. According to Army Brig. Gen. Loree Sutton, these screening tools are showing that 10-20 percent of returning troops have suffered at least a mild concussion.

If you are a soldier concerned that you may have suffered from a brain injury please call Centers of Excellence, 866-966-1020; and at the Defense and Veterans Brain Injury Center, 800-870-9244.

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Click here to read the full article

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, 9:12 am

Liveblogging the IA BIA Conference

I’m currently at the IA Brain Injury Association Conference in Des Moines, IA, where at least 300 registrees are finding out more about brain injury treatment and advocacy. It’s an exciting atmosphere.

Later today, Brookhaven’s own Ron Broughton will be speaking about what happens when a brain injury patient shows up in a psychiatric setting (which occurs much more often than you might suspect). Broughton is one of the rare individuals who knows the ins and outs of both mental health treatment and brain injury rehabiliation, so it’s going to be a critical talk for those involved in both fields.

During the same session, Dave Demarest, a gifted neuropsychologist with On With Life, will be speaking on the use of Ambien to help people emerge from comas, which is a current hot-topic in the field.

Following lunch, Dr. Rolf Gainer is delivering a talk called The Lifespan, which will trace the impact of brain injury on social role. One of the most important aspects about this topic is the inclusion of data about aging with a brain injury.

Both Brookhaven presentations will be available online in the upcoming weeks, so keep checking back for updates. In the meantime, if you happen to be in the area, please stop by and say hello.

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