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Jack Sisson's TBI Blog

A hug is duct tape for the soul.

 

A new cognitive test for detecting Alzheimer's disease is quicker and more accurate than many current tests, and could help diagnose early Alzheimer's, dementia, or mild cognitive impairment.

NOTE: At least one or more questions are specifically geared toward residents of the United Kingdom, so adjustments should be made for these for residents of other countries.

Researchers at the Addenbrooke's Hospital in Cambridge, England have developed a new test for Alzheimer's and dementia. Test Your Memory (TYM) is a short, on paper, test that can detect Alzheimer's disease at an early stage. The quiz takes about 5 minutes to administer.

The TYM is comprised of ten simple tasks including: the ability to copy a sentence, how items relate to each other, simple math, and the ability to recall.


In a clinical trial involving 679 people, the TYM detected 93 percent of people with Alzheimer's.

This compares with 52 percent for the Mini-Mental State Exam (MMSE). The MMSE is the test that doctors have been using for decades to detect mild cognitive impairment, dementia and Alzheimer's.


Score the test.
 

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From The Huffington Post
Dear Mr. President,
Please appoint a champion of non-pharmacological Alzheimer's treatment to the National Advisory Panel on Alzheimer's that you recently established pursuant to the National Alzheimer's Project Act.
Current medications can slow the advance of Alzheimer's disease in some people, but offer no hope of a cure for the estimated 5.5 million people with Alzheimer's or other dementias in the U.S. today, for the many millions more who will soon receive an early diagnosis of dementia, or for the even greater number of people who love and care for them. 
Mr. President, like most Americans, you probably know and love someone with dementia and you undoubtedly want a cure to be found for this horrible disease. But do you know that if a drug were discovered today it will not improve the lives of those with dementia now or of those who will soon develop it?
Drug development for dementia has hit a brick wall. The National Institutes of Health Consensus report states: "Currently, no evidence of even moderate scientific quality exists to support the association of any modifiable factor (such as nutritional supplements, herbal preparations, dietary factors, prescription or nonprescription drugs, social or economic factors, medical conditions, toxins, or environmental exposures) with reduced risk of Alzheimer's disease."

Here is the link to sign the petition to have a champion of nonpharmacological treatments for Alzheimer's appointed to the National Advisory Panel on Alzheimer's of the National Alzheimer's Project Act.

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From ABC News
Currently, there’s no foolproof way to ‘see’ damage from a concussion.  To give doctors a head’s up, researchers are testing a headband device that works like a scaled-down brainwave reader, and may pinpoint patients who have sustained a concussion.
It’s important for an athlete who has had a concussion to temporarily refrain from playing sports or other activities that could lead to another head injury. Research shows that the effects of successive or multiple head injuries can be cumulative and cause potentially serious, permanent brain damage.Coaches and trainers should know how to spot signs of a concussion in an athlete and, if necessary, send the player for an evaluation and medical clearance before allowing him/her to return to play. However, Jeffrey Bazarian, M.D., M.P.H., Emergency Physician with the University of Rochester Medical Center in Rochester, NY, says it’s often difficult to determine the extent of brain injury because some patients appear to be fine, but still have impaired function.
Bazarian is undertaking a study to test a concussion-detecting device from a company called, BrainScope™. The BrainScope device uses EEG technology to study brain waves of patients suspected of having a concussion. A headband with eight electrodes is placed over the forehead and temples. The electrodes detect and record brain wave activity and send the information to a handheld computer device. The computer analyzes the data and lets the physician know if the brain wave activity is within normal parameters. Bazarian says the auto-evaluation is important because emergency room physicians are not trained to read the results of an EEG and finding a neurologist to translate the readings takes extra time

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From The American Journal of Preventive Medicine
Abstract of Article
Although traumatic brain injury (TBI) is one of the leading causes of death and disability in the U.S., work-related TBI has not been well documented.
Purpose
The aim of this study was to describe the epidemiologic characteristics and temporal trends of fatal occupational TBI in the U.S between 2003 and 2008.
Methods
A cross-sectional analysis of the Census of Fatal Occupational Injury database was performed. Both the Occupational Injury and Illness Classification System nature of injury codes and body part codes were used to define TBIs. Fatality rates were calculated using denominators derived from the Current Population Survey. Fatality rates were compared among industries, cause of death, and demographics with rate ratios (RRs) and 95% CIs. Poisson regression was used to assess trends in fatality rates. Data were analyzed in 2009–2010.
Results
Nearly 7300 occupational TBI deaths occurred between 2003 and 2008, for an average fatality rate of 0.8 per 100,000 workers per year. The leading causes of occupational TBI death were as follows:
  • motor vehicle (31%);
  • falls (29%);
  • assaults and violent acts (20%); and
  • contact with objects/equipment (18%).
Fatality rates were 15 times higher in men compared with women. Workers aged 65 years or older experienced the highest TBI fatality rate of all age groups (2.5 per 100,000 per year). Construction, transportation, and agriculture/forestry/fishing industries recorded nearly half of all TBI fatalities . Occupational TBI death rates declined 23% over the 6-year period.
Conclusions
This study provides the first national profile of fatal TBIs occurring in the U.S. workplace. Prevention efforts should be directed at those industries with the highest frequency and/or highest risk. The construction industry had the highest number of TBIs, and the agriculture, forestry, and fishing industry had the highest rates. Additionally, workers aged 65 years or older in all industries would be a good target for future prevention efforts.
Go here to register at site or to purchase the complete article.

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From The Washington Post: 
Pat Summitt’s doctors are lucky they are still standing. When the first neurologist told her she had symptoms of early-onset Alzheimer’s disease, she almost dropped him with one punch. When a second one advised her to retire immediately, she said, “Do you have any idea who you’re dealing with?”
Three months ago, Summitt, 59, the blaze-eyed, clench-fisted University of Tennessee women’s basketball coach who has won more games than any other college coach ever, men’s or women’s, visited the Mayo Clinic in Rochester, Minn. seeking an explanation for a troubling series of memory lapses over the past year. A woman who was always highly organized had to ask repeatedly what time a team meeting was scheduled for. “She lost her keys three times a day instead of once,” her son Tyler says. She was late to practice. On occasion, she simply stayed in bed.
“Are you having trouble with your memory?” friends began asking, puzzled.
“Sometimes I draw blanks,” Summitt finally admitted.
Her first clue that something was badly wrong came last season, when she drew a blank on what offensive set to call in the heat of a game.
“I just felt something was different,” she says. “And at the time I didn’t know what I was dealing with. Until I went to Mayo, I couldn’t know for sure. But I can remember trying to coach and trying to figure out schemes and whatever and it just wasn’t coming to me, like, I would typically say, ‘We’re gonna do this, and run that.’ And it probably caused me to second-guess.”
Summitt believed her symptoms were the side effects of a powerful medication she was taking for rheumatoid arthritis, an excruciating condition that she has quietly suffered with since 2006. Instead, when Summitt received her test results from the Mayo Clinic at the end of May, they confirmed a shocking worst-case scenario: She showed “mild” but distinct signs of “early-onset dementia, Alzheimer’s type,” the irreversible brain disease that destroys recall and cognitive abilities over time, and that afflicts an estimated 5 million Americans.
Continue reading. 

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We used to think that our brains never changed once we reached adulthood. Then we learned that the brain is plastic and can alter itself. We've blogged about the brain's potential for regenerating itself after a neurological injury, and we've looked at various "brain aids" to help us preserve and/or improve our memories and cognitive abilities. Now, here's a list designed to help us alter our brains in specific ways. Some of these might surprise you...

From The Huffington Post

  1. Exercise your peripheral vision
  2. Memorize a song
  3. Learn to play a new instrument
  4. Don't rely on crossword puzzles and Sudoku
  5. Turn down the volume on your television
  6. Practice throwing a catching a ball up in the air
  7. Learn to use your "other hand"
  8. Choose to walk on bumpy surfaces
  9. Make a jigsaw puzzle
  10. Become a child again



Continue reading to find out how these activities can help your brain.

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From PsychCentral:
Traumatic brain injuries are known to trigger a variety of symptoms ranging from a simple headache to permanent memory and thinking problems. Now scientists at UCLA have discovered that a traumatic brain injury can result in the loss of a specific type of neuron, elevating the risk for Parkinson’s disease as well.

During a preclinical study, scientists found that a moderate traumatic brain injury in rats caused an initial 15 percent loss in nigrostriatal dopaminergic neurons, and that these brain cells continued to decline after the injury, leading to a 30 percent loss 26 weeks later.

A lack in these specific neurons can result in the cardinal motor problems found in Parkinson’s patients, including akinesia (problems with movement), postural tremor and rigidity. Furthermore, when combined with the pesticide paraquat — a second known risk factor for Parkinson’s — the loss of dopaminergic neurons climbed to 30 percent at a much faster rate.

Although traumatic brain injury was already known as a risk factor for Parkinson’s, scientists didn’t know exactly why. Nor was it known whether traumatic brain injury worked synergistically with pesticides such as paraquat, one of the world’s most commonly used herbicides, known to be toxic to human beings and animals and also linked to Parkinson’s.

Nigrostriatal dopaminergic neurons play a role in the production of dopamine, which is involved in the regulation of movement, among other things. The current research suggests that while a traumatic brain injury does not cause Parkinson’s, it can make individuals more susceptible to the disorder, said Chesselet.

“We found that with a moderate traumatic brain injury, the loss of neurons was too small in number to cause Parkinson’s disease, but it is enough to increase the risk of PD,” she said. “By decreasing the number of dopaminergic neurons, any further insult to the brain will be attacking a smaller number of neurons; as a result, the threshold for symptoms would be reached faster.”

Chesselet noted, “shortly after a traumatic brain injury, these neurons are more vulnerable to a second insult.”

Keep reading.

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From Home Care Assistance Vancouver Blog:

It’s been said that music is food for the soul, but recent studies have shown that it could be beneficial for your body and mind as well. Research done by Petr Janata, Associate Professor of Psychology, at the University of California found that the parts of the brain that that best responded to music “[stayed] healthier in Alzheimer’s patients longer than the other brain parts and [had] the capacity for emotions and other sensations.”

What this means is that music could potentially help stimulate Alzheimer’s sufferers no matter the stage of their condition. Listening to music evokes memories of childhood and youth, and serves to relax and soothe patients as well. In addition, music also helps with coordination and stimulation in Parkinson’s disease patients.

Play classical music to begin the calming process (but keep it to under an hour; patients were observed to become agitated past that), and sing and play instruments with your elder loved one. It won’t just help with motor functions and brain activity, but it’ll give you some quality time with them as well.

Read original article here.

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From The Los Angeles Times:

About to uncork that bottle of merlot? A study finds that moderate drinking may decrease the risk of dementia and cognitive decline in older people.

Researchers analyzed 143 studies that looked at the association between moderate alcohol consumption and mental abilities. The meta-analysis, published this month in the journal Neuropsychiatric Disease and Treatment, looked at research dating back to 1977.

Studies done between 1977 and 1997 mostly focused on younger people ages 18 to 54 and for the most part sought to determine whether moderate drinking had any damaging effects; Overall it didn't, said Michael Collins, the study's co-author and professor in the department of molecular pharmacology and therapeutics at Loyola University Chicago, Stritch School of Medicine.

Later studies from 1998 to the present focused more on mental status tests examining memory and cognitive function among mostly older people, he added, and most showed that drinking moderate levels of alcohol showed no effect or a decreased risk of dementia and cognitive impairment compared to control groups.

Among the studies surveyed, researchers found that this link was seen in 14 out of 19 countries, including the U.S.

Overall, those who drank moderately were 23% less apt to acquire dementia or other forms of Alzheimer's disease, or to develop some cognitive damage.

Heavy drinking, on the other hand, was linked with slightly higher risk of dementia and cognitive impairment that was not statistically significant. Heavy drinking was defined as having more than three to five drinks a day, and moderate drinking as one drink a day for women, two for men.

Keep reading.

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I believe we told you that Jack's Parkinson's diagnosis was an error. He does NOT have Parkinson's. What he HAS been diagnosed with is Dementia, and quite naturally he wants to learn everything possible about it. We will continue to post about Parkinson's from time to time, but our main emphasis will remain Traumatic Brain Injury with the addition of Dementia.

From PubMed Health:
Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

See also: Alzheimer's disease

Causes, incidence, and risk factors

Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the most common type of dementia.

Lewy body disease is a leading cause of dementia in elderly adults. People with this condition have abnormal protein structures in certain areas of the brain.

Dementia also can be due to many small strokes. This is called vascular dementia.

The following medical conditions also can lead to dementia:

Some causes of dementia may be stopped or reversed if they are found soon enough, including:

Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.

Symptoms

Dementia symptoms include difficulty with many areas of mental function, including:

  • Language

  • Memory

  • Perception

  • Emotional behavior or personality

  • Cognitive skills (such as calculation, abstract thinking, or judgment)

Dementia usually first appears as forgetfulness.

Mild cognitive impairment is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of the forgetfulness. Not everyone with MCI develops dementia.

Symptoms of MCI include:

  • Forgetting recent events or conversations

  • Difficulty performing more than one task at a time

  • Difficulty solving problems

  • Taking longer to perform more difficult mental activities

The early symptoms of dementia can include:

  • Language problems, such as trouble finding the name of familiar objects

  • Misplacing items

  • Getting lost on familiar routes

  • Personality changes and loss of social skills

  • Losing interest in things you previously enjoyed, flat mood

  • Difficulty performing tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines

As the dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of yourself. The symptoms may include:

  • Forgetting details about current events

  • Forgetting events in your own life history, losing awareness of who you are

  • Change in sleep patterns, often waking up at night

  • More difficulty reading or writing

  • Poor judgment and loss of ability to recognize danger

  • Using the wrong word, not pronouncing words correctly, speaking in confusing sentences

  • Withdrawing from social contact

  • Having hallucinations, arguments, striking out, and violent behavior

  • Having delusions, depression, agitation

  • Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving

People with severe dementia can no longer:

  • Understand language

  • Recognize family members

  • Perform basic activities of daily living, such as eating, dressing, and bathing

Other symptoms that may occur with dementia:


Continue reading. There's a lot more information on the PubMed page.

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Jack enjoyed this email he received a few days ago and hopes you do, too.

Q: Why are many coin banks shaped like pigs?

A: Long ago, dishes and cookware in were made of a dense orange clay called 'pygg'. When people saved coins in jars made of this clay, the jars became known as 'pygg banks.' When an English potter misunderstood the word, he made a bank that resembled a pig. And it caught on.


Q: Did you ever wonder why dimes, quarters and half dollars have notches, while pennies and nickels do not?

A: The US Mint began putting notches on the edges of coins containing gold and silver to discourage holders from shaving off small quantities of the precious metals. Dimes, quarters and half dollars are notched because they used to contain silver. Pennies and nickels aren't notched because the metals they contain are not valuable enough to shave.


Q: Why do men's clothes have buttons on the right while women's clothes have buttons on the left?

A: When buttons were invented, they were very expensive and worn primarily by the rich. Because wealthy women were dressed by maids, dressmakers put the buttons on the maid's right! Since most people are right-handed, it is easier to push buttons on the right through holes on the left. And that's where women's buttons have remained since.


Q: Why do X's at the end of a letter signify kisses?

A: In the Middle Ages, when many people were unable to read or write,documents were often signed using an X. Kissing the X represented an oath to fulfill obligations specified in the document. The X and the kiss eventually became synonymous.


Q: Why is shifting responsibility to someone else called 'passing the buck'?

A: In card games, it was once customary to pass an item, called a buck, from player to player to indicate whose turn it was to deal. If a player did not wish to assume the responsibility, he would 'pass the buck' to the next player.


Q: Why do people clink their glasses before drinking a toast?

A: It used to be common for someone to try to kill an enemy by offering him a poisoned drink. To prove to a guest that a drink was safe, it became customary for a guest to pour a small amount of his drink into the glass of the host. Both men would drink it simultaneously. When a guest trusted his host, he would then just touch or clink the host's glass with his own.


Q: Why are people in the public eye said to be 'in the limelight'?

A: Invented in 1825, limelight was used in lighthouses and stage lighting by burning a cylinder of lime which produced a brilliant light. In the theater, performers on stage 'in the limelight' were seen by the audience to be the center of attention.


Q: Why do ships and aircraft in trouble use 'mayday' as their call for help?

A: This comes from the French word m'aidez - meaning 'help me' –and is pronounced 'mayday.'


Q: Why is someone who is feeling great 'on cloud nine'?

A: Types of clouds are numbered according to the altitudes they attain, with nine being the highest cloud. If someone is said to be on cloud nine, that person is floating well above worldly cares.


Q: Why are zero scores in tennis called 'love'?

A: In , where tennis first became popular, a big, round zero on the scoreboard looked like an egg and was called 'l'oeuf,' which is French for 'egg.' When tennis was introduced in the U.S. , Americans pronounced it 'love.'


Q: In golf, where did the term 'Caddie' come from?

A: When Mary, later Queen of Scots, went to France as a young girl (for education & survival), Louis, King of France, learned that she loved the Scot game 'golf.' So he had the first golf course outside of built for her enjoyment. To make sure she was properly chaperoned (and guarded) while she played, Louis hired cadets from a military school to accompany her. Mary liked this a lot and when she returned to (not a very good idea in the long run), she took the practice with her. In French, the word cadet is pronounced 'ca-day' and the Scots changed it into 'caddie.'


Now YOU know just about everything!

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This is from Traumatic Brain Injury.com:

There are a number of resources available to the families and patients of a Traumatic Brain Injury (TBI). Hopefully this post will help you select the right kind of TBI treatment center for your needs.

Acute Hospitals

Acute hospitals provide emergency, neurosurgical and medical stabilization. Acute hospitals provide early treatment, stabilize complications and minimize neurological and related complications after TBI.

Trauma centers provide an expert, coordinated team approach to traumatic brain injury care. If the patient is taken to a hospital that is not a trauma center, ask for the nearest trauma center and request a possible transfer. Also, if the patient is not in an acute rehab unit within the acute hospital, request a transfer once the patient is medically stable.

The typical length of stay in an acute hospital varies based on the presence and duration of a coma, the need for neurosurgery, and multiple traumas.

Rehabilitation Units and Hospitals

Once the TBI patients is medically stable, a referral may be made to the acute rehab unit within the hospital setting, or to a freestanding acute rehabilitation hospital.

We suggest that the TBI patient receive rehabilitationcare in a setting where the team, physicians, nurses, therapists and staff have expertise in the management of traumatic brain injury.

The commission on accreditation of rehabilitation facilities (CARF) provides consumer information on accreditation and standard services for traumatic brain injuries. Not all rehab units, hospitals or facilities seek CARF accreditation, but these standards for providers can be used as a score card when selecting the best setting for acute rehabilitation.

Consult your insurer as early as possible about level of services for rehabilitation care that are covered by your policy, as well as anticipated/projected length of stay.

When selecting a treatment center, tour a few different units, hospitals or centers, if possible. Ask each treatment center for quality outcome data on TBI program.

If the TBI patient is unable to participate in therapy for at least up to three hours daily, ask if the program will find a way to increase tolerance and participation ability.

If the TBI patient is being recommended for transfer to a nursing home or other "rehab" center, ask for an estimate about the anticipated length of stay, as well as the possibility for transfer to an acute rehab program once therapy toleration improves.

If the patient has a mild brain injury and is discharged from the emergency room, ask for a referral to an outpatient brain injury program for neuropsychology evaluation and treatment. Be aware of the signs of mild TBI. Click for more information about Mild TBI symptoms.

Post Acute Rehabilitation Brain Injury Programs

After completion of an acute rehab program, the individual with a brain injury may

  • Return home to the community with home care
  • Be referred to a community-based brain injury program in a residential apartment setting
  • Return home with a referral to an outpatient program, preferably one that specializes in brain injury services for ongoing outpatient therapy, vocational services, day programs or a combination of these services
  • Be placed in a skilled nursing facility, or sub acute setting, as requested by the family. We recommend a setting that has experience managing traumatic brain injury medical and behavioral problems.
  • Choose intermittent respite care. This case may also be available in community-based brain injury programs, as well as skilled facilities.
  • Be recommendedto an assisted-living settings. Be sure to search for settings with expertise in brain injury. As an example, a typical Alzheimer unit is not appropriate for a TBI patient.

Some TBI patients may find that vocational rehabilitation programs with TBI expertise may also be a valuable resource when returning to both noncompetitive and competitive employment. State- funded offices of vocational rehabilitationservices may also be helpful in obtaining vocational evaluation and treatment.

Driver education and evaluation services may be available to TBI patients at local rehabilitation hospitals.

Other Resources To Contact

  • State brain injury associations (such as biapa.org for local head injury support groups
  • Local care giver support groups provided by your area rehab hospitals
  • Advocacy agencies
  • Your state's workers' compensation agency for additional resources for case management, vocational services, legal services and advocacy groups
  • CARF (commission for the accreditation of rehab facilities) for other resources
  • Your state's medical assistance waiver programs for possible financial resources and funding for program placement
  • Your state's head injury funding programs for eligibility for program evaluation and placement

For more information on other resource options:

Read at original source.

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Although this article is really a press release from a personal injury law firm, it still offers some good basic information and sound advice about traumatic brain injuries. Particularly helpful is the section on seeking an attorney. If you or someone you love suffers a traumatic brain injury, you should be aware of the economic toll such an injury can take ($600,000 to $1.8 million for lifetime expenses), and if the accident was someone else's fault, then hopefully their insurance company will provide financial compensation to help with medical bills, rehabilitation, loss of wages, and perhaps pain and suffering.

From U.S. Politics Today:
Every year, an estimated 1.7 million Americans suffer a traumatic brain injury ("TBI"). Fortunately, three quarters of TBIs are relatively minor. Even so, TBI is to blame for over 50,000 deaths annually, and some five million people currently live with TBI related disabilities. Knowing more about TBI and its causes can be beneficial for anyone whose life has been touched by a severe head injury.

TBIs can vary widely in severity. A concussion is a mild form of TBI that is usually not life-threatening (although the potential negative effects of a concussion should not be underestimated). More severe TBIs often involve lengthy periods of amnesia or unconsciousness. Permanent disabilities, or even death, are not unheard of in the most serious cases of TBI.

Warning signs of TBI immediately following an injury include any loss of consciousness or memory, a change in mental state or localized problems in nerve functioning. TBI can result in a diverse range of long-term effects as well. Some common issues include balance, coordination, or strength impairments, language and memory defects and emotional or behavioral disorders.

Falls, motor vehicle accidents and sports injuries are some of the most common causes of TBI. Motor vehicle, bicycle and pedestrian accidents alone account for about half of TBIs.

Many of the activities that can lead to TBI skyrocket in popularity during the summer months. Motorcycling and bicycling, for instance, are two warm-weather activities that bear a close relationship to TBI: head injuries are the leading cause of death and disability from cycling accidents.

For a suspected TBI sustained during any activity, it is imperative to seek immediate, competent medical attention. Every year, thousands of cases of traumatic brain injury are misdiagnosed or ignored. Even mild forms of TBI can cause long-lasting damage without treatment.

The economic toll TBI takes in terms of direct medical expenses as well as indirect costs like lost productivity annually exceeds $60 billion. The estimated lifetime care expenditures alone for someone suffering from a severe TBI are between $600,000 and $1.8 million. As burdensome as the financial costs of TBI can be, they pale in comparison to the loss of time, companionship and the health of a loved one.

After seeing to the immediate medical needs of a TBI victim, it is important to get in touch with an experienced personal injury attorney. You and your loved one may be able to recover monetary damages to help pay for medical bills, property damage and wages lost due to an inability to work, in addition to compensation for pain and suffering.

It is important to act quickly, however. If you wait too long, the statute of limitations can bar a lawsuit to recover for a TBI. In addition, it often becomes easier for an at-fault party to dodge responsibility for an accident as time goes on; witness memories fade, physical evidence disappears and it becomes more challenging for your attorney to complete a thorough investigation.

If you or a loved one has suffered a TBI, do not wait--call a personal attorney today to explore your legal options.

Read entire article.


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What a great idea! Read how one woman created a foundation to help brain-injured teens in a unique, fun way.

From the Key Biscayne Times:

Forget the pesky mosquitoes, the leaden sky, the toasty summer temperatures. The teen patients from Jackson Memorial Hospital’s outpatient pediatric rehabilitation program were ready to par-tee.

Friday’s barbecue at Crandon Park in Key Biscayne was both celebration and therapy for the six young men and women who, just months ago, were at death’s door. All had sustained traumatic brain injuries, mostly in car accidents, and had endured countless rehab sessions within the past couple of years.

As part of their therapy, Garcia, Blanco and the rest of the group go on outings — kayaking and sailing have been two of the most recent ones —- to familiarize the patients with life outside the hospital. The barbecue was a field trip to enjoy, of course, but it was also designed to teach. The group had to plan a menu, make a list of what was needed, shop for it at the supermarket, pay for their purchases, then, finally, help with the actual cooking.

Sounds simple? Not quite.

“These kids are like the walking wounded,” said Jackson recreational therapist Kelly Messett. “They look like normal teenagers, but their processing skills, their planning and organization, the short term memory, all these are a problem.”

Though the outpatient rehab group has been around for a while, the field trips were made possible only this year, with the funding of the Caviglia Bluewater Foundation, created in memory of the Miami businessman and champion sailor Alex Caviglia who suffered a traumatic brain injury after a kite-boarding accident in 2003. He lived for almost a year before dying unexpectedly from a blood clot.

Caviglia’s widow, Silvia, came to Crandon to watch the young people flip the meat on the barbecue and laugh as they pedaled around the park on rented Surrey bikes.

She wants to raise awareness of the devastating and lifelong effects of TBI through the foundation. There are a lot of charities and worthy causes, she said, but she feels a special affinity for people who suffer from traumatic brain injury, as her husband did.

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From ABC News:

Seven-year-old Enna Stephens is facing a daunting 16 months of chemotherapy and radiation after doctor's removed a tumor from her brain, but thanks to a bizarre side effect of the surgery -- all she can do is laugh about it.

Enna suffers from pseudobulbar affect (PBA), a neurological disorder brought on by nerve damage that makes it difficult to control one's emotional response. Some patients with PBA cry uncontrollably, others get angry, but for Enna, it has manifested as frequent bouts of the giggles.

'We were told by doctors that most patients who have a brain tumor removed feel depressed or angry afterwards. But when Enna came round she was giggling and it just carried on. She would giggle all the time – anything would set her off," Enna's mother Vana Stephens told the U.K. press.

While PBA can cause normal reactions, such as a chuckle following a joke, to become exaggerated, the emotional responses sometimes run contrary to the actual emotion the patient is feeling, or have nothing to do with it at all.

"Different patients suffer it in different ways," says Dr. Brian Greenwald, medical director of brain injury rehabilitation at the Mount Sinai Rehabilitation Center in New York City, who did not treat Enna. "Sometimes they'll be hysterically crying but not actually feel upset. Sometimes they are angry but it comes out as laughter. It can be incredibly frustrating to live with because it starts to interfere with one's social and professional life," he says.

In cases of traumatic brain injury, PBA can be a sign of damage to the brain and will often subside with time as the brain heals. For those with degenerative conditions, such as Parkinson's or Alzheimer's, however, PBA tends to worsen over time.

Though PBA is certainly not something one would wish for and Enna's PBA is expected to diminish, the little girl's parents note that this particular side effect has its silver lining:

"We'd visit Enna in hospital and try to put on a brave face but inside we were crushed. But once she started giggling we found ourselves doing the same. It was so infectious, and just a great way of releasing our emotions," Stephens told the U.K. press.

And according to Enna's doctors, there is something to smile about: they believe the cancer was completely removed and there is an 80 percent chance it won't return, doctors told the U.K. press.

Keep reading.

Here's more on Pseudobulbar Affect.

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From the Melbourne Weekly:
SITTING in front of a light box for 45 minutes a day is a promising treatment to reduce fatigue in patients with traumatic brain injuries, researchers have shown.

Light therapy has previously been used for seasonal affective disorder, studies showing that light hitting the back of the eye can stimulate changes to hormones in the brain and reset the body's circadian rhythm.

Professor of neuropsychology at Monash University, Jennie Ponsford, said she was initially sceptical about its potential to treat patients with traumatic brain injuries, who commonly suffer debilitating fatigue.

But preliminary results from a trial of about 30 patients from the Epworth Hospital, in Melbourne, is showing that the treatment is working to stimulate alertness, allowing people with head injuries to more easily perform daily tasks. Professor Ponsford said many patients treated for head injuries at the hospital were young, aged 15 to 30, and had been injured in car accidents. She said about 70 per cent experience fatigue, which is the most limiting factor for those able to return to work and study.

''It often means they are only able to work part time, or the effort expended in working means they just have to go home and go to bed,'' Professor Ponsford said.

Professor Ponsford said missing connections in the brains of head injury patients led to a range of problems including slowed thinking and difficulty planning and concentrating. She said those problems were likely to at least partly explain their fatigue, which then caused many patients to become depressed.

Professor Ponsford is working with a Monash University sleep expert, Associate Professor Shantha Rajaratnam, to pioneer the light therapy in head injury patients.

They are treating patients with different wavelengths of light, and monitoring a control group that receives no treatment. Those receiving the light treatment sit in front of a light box for 45 minutes within 90 minutes of waking up. Researchers are monitoring their fatigue and sleep patterns, reaction times, and levels of depression and anxiety, and have found that short wavelength light is having a significant impact.

Professor Ponsford said one participant, an academic with a mild head injury who had been struggling to function in a high-powered job, found the treatment had transformed his ability to work.

''People getting the [short wavelength light] therapy are coming back and saying, 'I want one of these boxes'. I must say I was very sceptical about the whole thing, it sounds a bit out there, but I really think it works,'' she said.

Researchers aim to recruit 90 patients in the trial, funded by the Victorian Neurotrauma Initiative, before publishing their final results.

Professor Ponsford said, if it was shown to be effective, the therapy would be a breakthrough in treating fatigue for brain injured patients.

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From The Houston Chronicle:
We encourage our children to play sports. As parents, we expect bumps and bruises, not a life-threatening head injury. Sports-related concussions continue to be reported at an alarming rate. According to the Centers for Disease Control, traumatic brain injuries occur frequently in contact sports. What's more, these injuries are now second only to car accidents among people aged 15 to 24. New laws are in place to protect our young athletes. Still, they may not be enough to keep them on the sidelines.
With the passage of House Bill 2038, school districts will now be required to have concussion oversight teams, composed of a doctor and at least one trained professional in the area of sports concussions. These oversight teams make the call on whether a student can return to play following a head injury. One requirement: Youth athletes must get written medical clearance before they can return to play. What's more, new University Interscholastic League rules that take effect this month will not allow athletes to return for at least one day. Players used to be allowed back onto the field after 15 minutes of not showing concussive symptoms.
While HB 2038 is being dubbed the most comprehensive and detailed in the nation, the law does not scrutinize the issue of written medical clearance. Getting a note from a health care professional to return to play is not the same as recommending an athlete who suffers a concussion be seen by a specialist. This includes a doctor who specializes in treating concussions or a medical doctor with training in concussion management. That's the recommendation of the American Academy of Neurologists, the largest association of doctors who treat the brain and nervous system. Concussions are often difficult to diagnose and do not always show up on CT scans or MRIs. Identifying concussions requires extensive knowledge.

Further, this law cannot account for concussions that go unreported. In high school sports, athletes often feel tremendous pressure to stay in the game. By some estimates, only half who suffer a head injury actually report it. This puts our youth at risk for second impact syndrome, or SIS. In SIS, a second concussion occurs before the first has properly healed. This leads to severe brain injury and sometimes death.

There has been some debate about whether baseline testing could be costly, ranging from $3 per athlete assessment and $10 to $15 for post concussive testing. Find the money. We are talking about our children's safety.

In professional football and hockey, players are required to undergo baseline health testing. Here in Texas, at least 60 high schools across the state are using baseline health testing for student athletes playing contact sports. It's time for all of our high schools to do the same. Baseline testing involves a computerized test, taking less than 30 minutes. The test establishes a player's reaction time and a baseline before a concussion. The player must be able to replicate that reaction time after a head injury before he or she can return to play. This takes some of the guesswork out of treatment.

We applaud the efforts of lawmakers in the passage of HB 2038, but it cannot end here. Sports should be fun and competitive, and playing sports should come with as much protection as we can provide. With school sports soon under way, we must not overlook the seriousness of concussions. We now know it can be more than just a bump or bruise. We can help lessen the blow by being proactive in how we clear our kids to return to play and through baseline testing.


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From San Diego's North County Times:
I don't think I've ever seen anyone so happy to receive a check in the mail as "Ann Norris," who asked me not to use her real name to protect her privacy.

It's not as if it's a huge check either, but it's going to help cover her house payment and lift some of the worry and guilt she's been carrying since May 2005. That was when her son, "Rob," returned from his deployment in Iraq with extreme symptoms of post-traumatic stress and a traumatic brain injury (TBI).

For more than six years, Norris has had to wage her own war ---- and is still fighting ---- for Rob to receive the ratings, treatment and benefits he is owed by the Army and the Veterans Affairs ---- in between taking him to doctors' appointments, monitoring his medication and doing his shopping and cleaning.

Besides PTSD and TBI, Rob has also been diagnosed with a psychotic disorder. For the first few years after his return, his family never knew when there would be another crisis involving the police. Norris says she's been "on call 24/7 for the past six years."

Before his military service, Rob was a popular kid who loved playing the guitar and surfing. Even now, the one thing that brings him peace is being on his boat in the ocean. His mom still calls him her "gentle giant."

Before she became Rob's caregiver, Norris was an energetic and successful Realtor. She and Rob's dad were saving towards retirement. But she had to let her business go so she could care for her son, and the burden of income fell on her husband. Which is where the guilt came in. And the constant struggle to make ends meet.

"Just as Rob was forever changed by the war, so were we," she says. The friends Rob had before he went to Iraq no longer want to see him. Many of Norris' extended family members and friends stay away, too. Exhaustion and worry are etched in her face and eyes. But less so since her first caregiver stipend from the VA arrived last month. Besides helping to cover the mortgage, it validates what she spends her days doing.

The VA has finally recognized that caregivers of post-9/11 veterans provide crucial support in caring for veterans and that the home environment can enhance the health and well-being of veterans under VA care.

Under the "Caregivers and Veterans Omnibus Health Services Act of 2010," additional VA services are now available, and the VA is now accepting applications for these services. Go to http://www.caregiver.va.gov/ or call VA's Caregiver Support Line (1-855-260-3274).

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From Philadelphia Magazine:

Researchers examined brain tissue of former athletes and found that traumatic brain injury can lead to an Alzheimer's-like disease later in life.
About this time every year, as high school football season gears up, we start hearing stories about the health risks associated with contact sports—especially when it comes to kids. There’s good reason: The Centers for Disease Control and Prevention reports that each year emergency rooms see an estimated 135,000 sports-related concussion cases in kids ages 5 to 18.

In all, about 1.7 million people sustain traumatic brain injury annually; of those, more than 50,000 people die.

A new study of professional and high school athletes found that those who suffered repeated blows to the head are at risk for developing a brain disease called chronic traumatic encephalopathy (CTE). It surfaces years later in the form of memory loss, mood disorders and, in some cases, early dementia. The California researchers who conducted the study reported their results in this month’s issue of Neurosurgery.

Keep reading.

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From Central Florida's WFTV.com:
Comas typically only last a few weeks, and most people do come out of comas, but whether they can return to a functioning life is the question. Transcranial magnetic stimulation (TMS) may help with this problem. TMS could help the more than 300,000 soldiers who have returned from Iraq and Afghanistan with brain injuries.

WHAT IS IT?: TMS uses strong magnetic fields to induce or inhibit electrical activity in brain neurons, therefore either turning off or stimulating parts of the brain. TMS activates different areas of the brain depending on the severity of the coma. When one is in a coma, it can be caused by several factors, but damage to the brain is often seen. When in a coma, the brain is at its lowest functioning level. TMS stimulates a damaged brain so that it functions more.

It's like jumpstarting the brain. TMS poses little discomfort for the patient and is generally thought to be safe. Some side effects may include seizures, minor headaches and fainting.

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Here's something surprising, at least it was to me.

From Boomer Health & Lifestyle:

A study in the Winter 2007-2008 edition of Journal of Athletic Training reports a number of surprising findings about girls and concussions:

- Girls playing high school soccer suffer concussions 68 percent more often than boys playing the same sport;

- Girls appear more susceptible to concussions in sports like soccer and basketball than boys;

- Concussion rates in high school basketball were almost 3 times higher for girls than for boys;

- Girls took much longer than boys for concussion symptoms to resolve and return to play

Reasons for these difference remain unclear, but research has shown that it could be linked to anatomy. Girls generally have smaller heads and less developed neck muscles than boys.

Read the entire article.

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