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Tuesday, December 6, 2011

Soccer 'Headers' Linked to Brain Injury

The ‘non-contact sport’ of soccer may now be linked to traumatic brain injuries (TBI) for certain players.

A study by the Albert Einstein College of Medicine of Yeshiva University in New York of 38 amateur soccer players found that frequent and repeated ‘heading’ of soccer balls may cause TBI.  The study established a threshold of 1000-1500 headings a year as the point where injury was most likely to occur.

"Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibres in the brain," said Michael Lipton, M.D., Ph.D., director of radiology research at the Albert Einstein College and lead author of the study.  "But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells."

Researchers used diffusion tensor imaging (DTI) to study the effects of soccer 'heading' and found that players who met the threshold number of headings have abnormalities similar to those found in TBI patients.  The researchers identified five areas, in the frontal lobe (behind the forehead) and in the temporo-occipital region (the bottom-rear areas) of the brain that were affected by frequent heading.  Those areas are responsible for attention, memory, executive functioning, and higher-order visual functions.

Dr. Lipton and colleagues also gave the same 38 amateur soccer players tests designed to assess their neuropsychological function.  Players with the highest annual heading frequency performed worse on tests of verbal memory and psychomotor speed (activities that require mind-body coordination) relative to the other players.

"These two studies present compelling evidence that brain injury and cognitive impairment can result from heading a soccer ball with high frequency," Dr. Lipton said.  "These are findings that should be taken into consideration in planning future research to develop approaches to protect soccer players."

Heading is currently an essential part of the game and the focus of many training drills.  However, Dr. Lipton hopes his team’s findings will be used to create safe guidelines for play, especially for younger players, in the future.  The American Academy of Pediatrics currently recommends that adults who supervise participants in youth soccer should minimize the use of heading the ball until the potential for permanent cognitive impairment is further studied.

Wednesday, November 16, 2011

Gabby Giffords' Road to Recovery Is Simply Remarkable

Congresswoman Gabby Giffords is certainly an inspiration for those who suffer from a traumatic brain injury (TBI).  Her remarkable road to recovery was well documented and shown on the recent ABC 20/20 Episode

Statistically, only about 10% of those who are shot in the head even survive.  Severe brain injuries, such as from gunshot wounds, can leave the victim with physical disabilities, cognitive problems, and behavioral symptoms. The potential physical symptoms can run from total or partial paralysis to things like vision and speech problems, and general fatigue. Cognitive and behavioral disabilities from a severe brain injury can pose devastating problems for the victim too. There are innumerable cognitive and behavioral issues that a TBI victim may have to deal with, including attention, concentration, learning, and memory issues, as well as depression, irritability, and inappropriate behavior issues. Recovery from such a devastating injury is very slow, and improvements can continue to be seen months up to several years later. Some of the recovery is attributable to rewiring of neurons in the brain, sprouting new connections to attempt to regain their former functions and take over functions of the neurons that were lost.

As shown with Congresswoman Giffords, one of the most important parts of the rehabilitation process is family understanding and support for the TBI victim. Dealing with the effects of TBI is a lifelong issue for the family, as well as the victim.

Monday, November 7, 2011

Public Documents Need Not Be Automatically Disclosed in Litigation in Colorado

Today I'm changing my post's focus from traumatic brain injury ("TBI") issues, to legal issues from the Colorado Supreme Court's opinion that came out today in Averyt v. Wal-Mart, because of the significance it has to cases filed in Colorado, including TBI injury cases The Court in Averyt essentially carved out an exception to a party in a lawsuit's mandatory automatic disclosure of documents obligation under the Colorado Rules of Civil Procedure for "public documents."  Rule 26(a)(1)(B) states, "[e]xcept to the extent otherwise directed by the court, a party (to a lawsuit) shall, without awaiting a discovery request, provide to other parties: . . . [a] listing, together with a copy of, or a description by category and location of, all documents, data, compilations, and tangible things in the possession, custody, or control of the party that are relevant to disputed facts alleged with particularity in the pleadings. . ." C.R.C.P. 26(a)(1)(B)(parentheses added). 

In summary, the court in Averyt ruled that a City of Greeley public document - a document that could have been located equally by either the plaintiff or defendant in the lawsuit - did not have to be disclosed by the party that actually found the document after the trial that already started.

This is a very significant ruling in Colorado because now, each party in a lawsuit must be diligent in doing their own research into finding public documents that are relevant to their specific case.  The court in Averyt specifically mentioned a few public documents that do not have to be automatically produced under Rule 26(a)(1)(B): newspaper articles, minutes from meetings of governmental bodies, customer reviews, reports of health and safety inspections, complaints lodged with business rating agencies, grievances filed with professional licensing authorities, and even legal documents filed in other cases.  But the court did not foreclose the possibility that a party could still obtain, either through written discovery or depositions, information about another party's knowledge or possession of a public document. 

With this new ruling, victims of accidents should be even more diligent in finding a personal injury attorney to represent them who is knowlegable and who is going to work hard to find all the relevant public documents that could affect their case.  At Nelson Law Offices, we are dedicated to doing just that - building strong personal injury cases for all persons who are the victim of the negligence of others. 

Wednesday, October 19, 2011

Cholesterol Drugs Studied for Traumatic Brain Injury Patients

A Johns Hopkins study reported in the Journal of Trauma found that cholesterol-lowering statin drugs may have a role in the treatment of traumatic brain injuries (“TBI”).  Older adult TBI victims, who had previously been on cholesterol-lowering statin drugs such as Lipitor and Mevacor, when hospitalized with serious head injuries, were 76 percent more likely to survive than those not taking the drugs.  The prior use of statin cholesterol drugs was also associated with improved functional recovery at 12 months post-injury for those older patients.  However, those TBI victims with heart disease did not benefit from the prior statin drug use.

Eric B. Schneider, an epidemiologist at Johns Hopkins University, believes that it is not the lowering of cholesterol that’s helping the brain recover, but that there are other, less well-known properties of statins that are causing these results.  Statins also have an anti-inflammatory effect, and they also are known to modulate the body’s immune response.  Schneider wants to now do a clinical trial administering statins to brain-injured patients, not already on the cholesterol-lowering statin drugs, immediately upon arrival in a hospital emergency department to see if the same effect is achieved.

The researchers have cautioned that they cannot recommend that statins be used as a blanket treatment for TBI patients at this time, because there are unknowns and downsides to the drugs, including the risk that some people may develop serious muscle disorders.  But if a significant benefit in patients treated with statins after a TBI were found, it would open up a wide variety of possibilities for its use, including giving statins people who are likely to be exposed to mild TBI, such as football players or soldiers in combat.

Monday, October 3, 2011

October 5th Free Lecture on Sports Concussion at Boulder High School

Register for Lecture Now

Hits to the head are almost unavoidable in contact sports. But with any bump to the head, caution should be the name of the game. That bump could cause a concussion.

Concussions are brain injuries that can lead to long-term problems — memory loss, chronic headaches, concentration difficulties — and, in some cases, death. Getting medical help quickly offers the best chance for avoiding serious consequences. Unfortunately, concussions can be difficult to spot.

Learn the warning signs of concussion and when a hit to the head should mean a trip to the doctor or emergency room. Then get a review of treatment options and rehabilitation for concussions.
Speakers
Jason Glowney, MD, board-certified sports medicine physician
Julie Stapleton, MD, board-certified physiatrist specializing in neuro-trauma
When
Wednesday, Oct. 5, from 7 to 8 p.m.
Where
RSVP
Reservations required.
Call 303-441-0580 or visit bchlectures.org/concussion to register.

Register Now

http://www.bchlectures.org/1011/images/concussion.pdf

Friday, September 30, 2011

Blood Protein Test May Help Diagnose Concussions

Doctors in Cleveland, Ohio are currently conducting a study on local college football players, testing their blood for a protein that could indicate they’ve sustained a concussion.  The blood samples are being screened to see if they contain a protein that's known to leak into the blood after sustaining a head injury.

If the study confirms the predictive value of the protein, it could lead to simple blood tests to confirm concussions.  Traumatic brain injury (TBI) accounts for more than 1 million emergency room visits each year throughout the US. 
 
The test could also help track the long-term effects of high-impact sports like football or boxing, and it could be valuable to the military, as soldiers often face head injuries caused by the pressure wave from bomb explosions.

Friday, August 5, 2011

Higher Risk for Dementia for TBI Victims

A new study revealed that Traumatic Brain Injury (TBI), whether mild, moderate, or severe, has been linked to a doubling of risk for dementia.
 
Presented at this year's Alzheimer's Association International Conference in Paris, France, a seven year study of veterans over 55 found that the veterans with TBI were twice as likely to develop dementia over that 7 year period of time, with 15% of the TBI veterans vs 7% of non-TBI veterans developing dementia.

"[The findings] suggest TBI may predispose people to earlier manifestation of [dementia] symptoms and raises hope that treatment or rehabilitation may have a role in preventing downstream dementia," says Kristine Yaffe, MD, professor of psychiatry and epidemiology, University of California, San Francisco and director of the Memory Disorders Program at the San Francisco Veterans Affairs Medical Center.

According to Dr. Yaffe, the most plausible explanation for the relationship between increased dementia in TBI victims is that diffuse axonal injury, or swelling of the axons that form connections between the neurons, would disrupt neuronal communication.

Clinicians need to recognize TBI as a major risk factor for dementia, and individuals who have sustained a head injury constitute a group that should "probably be followed very carefully as they age and be screened for dementia and other cognitive problems," Dr. Yaffe said.

TBI is a widespread problem, far too common among veterans, as well as car accident victims, athletes, people who experience falls, and many others.  The Centers of Disease Control and Prevention estimates that approximately 1.7 million TBI-related deaths, hospitalizations, and emergency department visits occur in the United States every year.

Thursday, July 21, 2011

NFL Sued for Concealing Effects of Multiple Brain Injuries on Players

Seventy-five former NFL players filed a lawsuit in Los Angeles Superior Court this week, alleging that the league has covered up the harmful effects of concussions for almost 70 years.  

All of the players in the litigation claim they suffered injuries as a result of multiple concussions.  They contend the injuries left them with problems such as dementia, headaches, memory loss, blurred vision, sleeplessness and ringing in the ears.  Some claim the injuries caused depression, anxiety, "explosive mood changes," poor judgment and substance abuse.

The suit alleges that “the NFL knew as early as the 1920s of the harmful effects on a player’s brain of concussions; however, they concealed these facts from coaches, trainers, players and the public.”  The suit also names helmet-maker Riddell, the NFL's official helmet supplier, as a defendant.

The suit claims the NFL commissioned a study in 1994, titled "NFL Committee on Mild Traumatic Brain Injury" that published a "false, distorted and deceiving" report in 2004, concluding there was "no evidence of worsening injury or chronic cumulative effects" from multiple concussions.

The suit alleges that the NFL finally acknowledged in June 2010 that concussions can lead to dementia, memory loss, and chronic traumatic encephalopathy (CTE).  CTE is a degenerative brain condition that has been linked to the deaths of several former NFL players, including former Chicago Bear Dave Duerson and former Cincinnati Bengal Chris Henry.

Even though this litigation could take years of trials and appeals before any final conclusion, its affect could potentially change the future of the NFL and how players' traumatic brain injuries are assessed and handled.

Thursday, June 23, 2011

Mild Traumatic Brain Injury Android Mobile App For Health Care Professionals


The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) teamed with the National Center for Telehealth and Technology (T2) to develop a mobile application called the Mild Traumatic Brain Injury (MTBI) Pocket Guide.  It is a free mobile application developed to provide health care professionals with a comprehensive, quick reference that includes clinical practice guidelines for assessing and treating service members and Veterans who have sustained a MTBI

App Screenshot



The mobile application is free and available for download on Android smartphones.  It is not yet available for iPhone users.  Since the mobile application was specifically intended for healthcare professionals who care for service members and veterans, it is not currently appropriate for use for other victims of a MTBI.  To download the app, go to: https://market.android.com/details?id=org.t2health.mtbi

Friday, June 17, 2011

New MMR Device Approved to Diagnose Traumatic Brain Injuries

A new device was recently cleared by the FDA to help diagnose brain injuries in patients.  The Siemens Biograph mMR system is the first machine to simultaneously perform a positron emissions tomography (PET) scan and a magnetic resonance imaging (MRI) scan.

PET scans involve a radioactive injection that traces blood flow, while MRIs produce images of the brain through the use of magnetic fields.

“The Siemens PET/MRI system allows two tests to run simultaneously without having to move the patient to a different scanning system,” said FDA representative Alberto Gutierrez in a statement.  “Minimizing changes in a patient’s position between tests allows for physicians to compare images more easily and helps them get the most accurate information possible.”

The two-in-one scanner both saves time and reduces radiation levels exposed to patients.  The system has been cleared for anyone who needs diagnostic PET or MRI imaging, with an exception for people with implanted electronic devices like pacemakers or defibrillators.

Friday, May 6, 2011

TBI May Be Helped By Early Nutrition Intervention

A report by the Institute of Medicine, commissioned by the U.S. Defense Department, recommends that in the first 24 hours after a traumatic brain injury (TBI), patients need to receive a level of nutrition that represents more than 50 percent of the injured person’s total energy expenditure and that provides 1 to 1.5 grams of protein per kilogram of body weight.  This nutrition level should be continued for two weeks in order to reduce inflammation and swelling of the brain and provide enough energy to help the brain repair itself.  Early feeding was found to mitigate the effects of head injuries and reduce mortality in critically ill people by between 25% and 50%.

 "The one major [conclusion] is a focus on getting protein and calories in as quickly as possible," said John Erdman, a nutrition researcher at the University of Illinois, who headed the panel of independent experts that produced the report.

 TBI among U.S. soldiers is a growing problem.  The Defense Department says reported cases have tripled to more than 30,000 in the past decade, reflecting injuries from so-called improvised explosive devices, or IEDs, that troops frequently encounter in Afghanistan and Iraq.

 Also, because of the parallels between some types of TBI found in combat personnel and those found in civilian brain injuries, such as concussions from traffic accidents and sports-related injuries, the nutritional interventions explored in this report are relevant for nonmilitary populations.

 Outside the military, some 52,000 people in the U.S. die each year from TBI, and about 1.5 million patients report to emergency rooms annually with head injuries.  As many as 3.8 million people suffer such injuries playing sports each year, says the Brain Trauma Foundation.

 The Institute of Medicine’s committee suggests that more research be conducted on a number of other possible benefits for nutritional interventions in TBI victims, including any long-term benefits of nutrition.

Friday, April 29, 2011

Long-Term Depression Linked to TBI

About 30 percent of traumatic brain injury (TBI) patients will develop clinical depression, a level three times higher than the general population, according to a new study from Vanderbilt University.  By examining more than 100 previously published studies done over several decades on patients that had experienced TBIs resulting from motor vehicle accidents, falls, assaults, and sports injuries, the Vanderbilt researchers were surprised to discover that the incidence of depression seems to hold steady for people with TBIs even years later.

 “Any patient who has a traumatic brain injury is at a real risk for developing depression, short and long term,” said Dr. Oscar Guillamondegui, study co-author and professor in Vanderbilt’s Division of Trauma and Surgical Critical Care. “It doesn’t matter where on the timeline that you check the patient population – six months, 12 months, two years, five years – the prevalence is always around 30 percent across the board.  In the general population about 9 percent to 10 percent of people have depression.”

 The study didn’t show a distinction between mild and severe brain injuries, meaning a patient who sustains a concussion might be just as likely to develop depression as one with a fractured skull and severe bleeding on the brain.

 “Nine months out, they may have developed depression as a result of the injury, but because the injury seemed mild they may not have had a visit with a physician who could pick up on the problem,” said study co-author, Melissa McPheeters, a health-care epidemiologist and co-director of Vanderbilt’s Evidence-based Practice Center.

 “Patients and their families need to know about this,” McPheeters said. “They need to know what to look for because they are the ones who will see the changes first.”

 The researchers also suggested that practitioners should ask about whether a patient has a history of TBI, when they are initially seen for symptoms such as irritability, restlessness, anxiety, and sleeplessness, so that both conditions can be treated together.

Wednesday, April 13, 2011

Research Underway to Develop Drug to Help TBI Victims

A chemistry professor at the University of Notre Dame is working on research intended to create a drug that could be given to a patient immediately after a traumatic brain injury to slow or reduce injury to the brain.  In December, Professor Mayland Chang received a $100,000 grant from NFL Charities (a charitable foundation of National Football League owners) to design and develop a drug for the treatment of TBIs.  When a brain suffers an injury, it causes biochemical changes that lead to tissue damage and the death of some brain cells.  Professor Chang and a colleague at the University of Missouri have been working on developing and defining inhibitors to block those chemical changes, potentially saving brain cells that otherwise would die.  They have found that some compounds will rescue as much as 60% of the brain that was destined to die.  Chang is currently testing a compound she developed on mice.  But human testing is still several years away. 

Friday, April 1, 2011

Opening Day for Colorado Rockies Brings New TBI Protocols

Major League Baseball and the Major League Baseball Players Association have adopted a new series of protocols under the new joint policy regarding concussions.

The biggest change is the creation of a seven-day disabled list (DL) which can be used instead of rushing a player back too soon after a possible concussion or placing him on the 15-day disabled list.  The seven-day disabled list will aim to allow time for the concussion to clear, prevent players from returning prematurely, and help clubs keep a full complement of players during the player’s absence.  If a player on the seven-day DL is out for more than 14 days, he will automatically and retroactively be transferred to the 15-day DL, effective with the first day of the initial placement, and with the prior 14 days applying to the initial 15-day maximum term.  This is implemented on a trial basis for the 2011 season.

Some of the other new key protocols include:

•Mandatory baseline neuropsychological testing requirements for players and umpires during Spring Training, or when a player joins a club during the season, formalizing a process that most individual Clubs follow;

•Protocols for evaluating players and umpires for a possible concussion, including during incidents typically associated with a high risk, such as being hit in the head a by a pitched, batted or thrown ball or by a bat; being in a collision with a player, umpire or fixed object; or any time when the head or neck of a player or an umpire is forcibly rotated; and

•Protocols for clearing a concussed player or umpire to return to activity; prior to the time that a concussed player is permitted to play in any game (including Major League, Minor League or extended Spring Training games), the Club must submit a “Return to Play” form to MLB’s Medical Director; submission of the form is required irrespective of whether the player was placed on the Disabled List.

A committee of experts created the policy, which will oversee the manner in which concussions are diagnosed initially and will be used to determine when players and umpires can return to the field following a concussion.  The Commissioner's Office will conduct an orientation for club medical staffs regarding the new protocols, and each club will be required to have a mild traumatic brain injury specialist in its home city.


Wednesday, March 30, 2011

Jake Snakenberg Youth Concussion Act signed by Governor

Just yesterday Gov. John Hickenlooper signed into law a bill that requires coaches of youth sports to be educated about concussions.  It requires that coaches receive education on how to recognize a concussion, that a player is removed from play if a concussion is suspected, and that the student athlete must be signed off by a medical professional before returning to play.

The law applies to coaches of all public and private middle schools, junior high schools, high schools, club, and recreation youth athletic sports.

"Most likely, kids this age do not have the knowledge to recognize themselves the symptoms of a brain injury," State Senator Nancy Spence (R-Centennial), a sponsor of the bill said.  "This bill is one that will keep athletes active and safe."

The proposed bill is named in memory of Jake Snakenberg, who was a 14-year old freshman football player at Grandview High School when he passed away after suffering from what doctors diagnosed as Second Impact Syndrome.  Doctors believe that in the previous week’s game, Snakenberg suffered an undiagnosed concussion and had not recovered before returning to the field and subjecting the brain to further injury.   Snakenberg died of a closed head injury in September 2004 at the age of 14, a day after collapsing during a Grandview freshman football game.  My son Drew was also 14 in 2004 when he suffered several successive concussions during sports activities, ultimately sustaining a large left-sided epidural hematoma.  This bill, which becomes effective January 1, 2012, will hopefully prevent any further young Colorado athletes from permanent injury or death as a result of participation in youth sports activities.

Friday, March 25, 2011

LEDs As Treatment for TBI Patients

A study by Margaret Naeser, PhD, from Boston University School of Medicine and colleagues from Massachusetts General Hospital and Harvard-MIT Division of Health Sciences and Technology in Boston, has found that daily self-administered light therapy via light-emitting diodes (LEDs) can lead to improvements in cognitive function in traumatic brain injury (TBI) patients as well as improvements in post-traumatic stress disorder.

Two longstanding TBI patients were in the study.  One sustained a closed-head TBI in a motor vehicle accident (MVA) in April 1997, while the other one was suffering from cognitive dysfunction due to an accident in which she fell backwards from a swing, hitting the back of her head on concrete.

Each patient applied red and near-infrared (LEDs) to their forehead and scalp areas every night.  Following treatments with LEDs, both patients demonstrated substantial improvement in cognitive function, including improved memory, inhibition, and ability to sustain attention and focus.  Both patients are continuing LED treatments in their homes.

Prior to LED therapy, one patient was on medical disability for 5 months. After 4 months of nightly LED treatments at home, she was able to discontinue medical disability and return to working full-time as an executive consultant with an international technology consulting firm.

The findings are published under the heading 'Improved Cognitive Function After Transcranial, Light-Emitting Diode Treatments in Chronic, Traumatic Brain Injury: Two Case Reports' in Photomedicine and Laser Surgery, a peer-reviewed journal.

Raymond J. Lanzafame, MD, MBA, Editor-in-Chief of the Journal, said "The results of this study will provide a basis for future therapeutic use of phototherapy to improve recovery after injury and facilitate management of other CNS disorders.”

Friday, March 11, 2011

March is Brain Injury Awareness Month

March is Brain Injury Awareness Month.  According to the Brain injury Association of America (BIAA), every 23 seconds, someone in the U.S. sustains a traumatic brain injury (TBI).  Individuals who sustain brain injuries must have timely access to expert trauma care, specialized rehabilitation, lifelong disease management and individualized services and supports in order to live healthy, independent and satisfying lives.
 
Concussions are TBIs.  According to the Brain injury Association of America: “A concussion is caused by a bump, blow or jolt to the head, or from a blow to the body that causes the head to move rapidly back and forth. Most concussions occur without a loss of consciousness and according to the Centers for Disease Control and Prevention (CDC), a lack of proper diagnosis and management of concussion may result in a serious long-term consequences, or risk of coma or death. Signs and symptoms may be noticeable immediately, or it may take days or weeks before they are present.

According to the CDC, an estimated 3.8 million sports- and recreation-related concussions occur in the United States each year. Of that number, U.S. emergency departments treat approximately 135,000 sports- and recreation-related traumatic brain injuries (TBIs), including concussions, among children ages 5 to 18.

Signs and Symptoms of Concussions can include:
• Nausea (feeling that you might vomit)
• Dizziness or balance problems
• Double or fuzzy vision
• Sensitivity to light or noise
• Headache
• Feeling sluggish or tired
• Feeling foggy or groggy
• Confusion
• Trouble concentrating
• Trouble remembering

TBIs are often misdiagnosed and misunderstood.  A community of people including surviving victims, spouses, fathers, mothers, sisters, brothers, significant others, friends, neurologists, neuropsychologists, counselors, service coordinators, occupational therapists, legislators, advocates, brain injury association members, certified homecare aides and many others from a host of disciplines and backgrounds must work together towards a common cause of helping to diagnose, prevent, and treat TBI.

At Nelson Law Offices, we have the knowledge, the passion, and the experience to assist TBI victims throughout the often difficult process of diagnosing the injury and presenting it in court.

Friday, March 4, 2011

Acupressure May Help Traumatic Brain Injury Patients


A study published in the January 2011 issue of the Journal of Neurotrauma found that Jin Shin Jyutsu – the ancient Japanese art of releasing accumulated tension through acupressure – may be an effective treatment to help people with mild traumatic brain injury (TBI).

Lead author of the study, Professor Theresa Hernandez, from the University of Colorado, found that treatment with Jin Shin, in which gentle fingertip pressure is applied to 26 points of the body, done in a certain sequence to awaken the body's natural power of self-healing, enhanced the cognitive function in people suffering from TBI.  Meridians are the places where acupressure points are located, which are connected to various energy pathways in the body that are connected to the health of specific organs including the brain.

Neuropsychological tests were given to study participants who received the Jin Shin treatments and to those in the control group who were given acupressure treatments to areas of the body that were not considered to be Jin Shin acupressure points.  Participants who received the Jin Shin acupressure treatments showed improved cognitive function, scoring significantly better on tests of working memory when compared to the TBI subjects in the placebo control group.

The study was funded by the Colorado Traumatic Brain Injury Trust Fund[1] and is believed to be one of the first placebo-controlled studies ever published in a peer-reviewed medical journal, showing the benefit of acupressure to treat patients with TBI.

Friday, February 11, 2011

Jake Snakenberg Youth Concussion Act Progresses through Colorado's Senate

Yesterday the Jake Snakenberg Youth Concussion Act, SB11-040, passed 7-2 in Colorado's Health and Human Services Senate Hearing Committee and is now on to the full Senate and then to the House.  We've been monitoring this bill which requires coaches who deal with 11-18 year old athletes in Colorado schools, private sports clubs, and recreation centers to attend annual concussion recognition courses.  It also requires coaches to remove the player from the game, competition, or even practice if they suspect that the young athlete has sustained a concussion. 
For more information on the training that the bill would require coaches to go through, see: http://concussion.orcasinc.com/

The complete bill, as introduced, together with the bill’s history can be found at: http://www.leg.state.co.us/clics/clics2011a/csl.nsf/fsbillcont3/A9CE9CEE12645CAA8725780800800D80?open&file=040_01.pdf 

Wednesday, February 2, 2011

ImPACT Concussion Testing for Athletes

As Super Bowl Sunday 2011 approaches, sports concussion brain injury concerns are more prevalent in the news.  For some athletes, ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) computer software is being used to test athletes to determine if they have suffered a brain injury.  Athletes are first given a baseline test, which is then used as a comparison to tests given after the athlete experiences symptoms of a traumatic brain injury in sports activities.  The computer test asks simple questions and records response times and other factors.  It measures players’ verbal and visual memory, processing speed, and reaction time to within 1/100 of a second.  The test is used to help clinicians and athletic trainers determine when/if the athlete can return-to-play the sport after a concussion.  The test itself takes about 20 minutes to complete and measures different aspects of cognitive functioning.  The test is more of an objective measure of the athlete’s condition, instead of relying on the athlete’s own reporting of how he is doing or the trainer’s subjective opinion. 
This computerized testing program is already being used by teams in the National Football League (both the Packers and the Steelers are users of this software), as well as the National Hockey League, Major League Baseball teams, Major League Soccer teams, some National Basketball Association teams, Professional Automobile Racing associations, and is being used at the US Olympic Training Center in Colorado Springs.  Also in Colorado, many colleges and universities, such as CU, CSU, and DU are using the software for their athletes.  High Schools around the state are using the software too.  Additionally, some clinics and hospitals, including The Children’s Hospital and Vail Valley Medical Center are using the software.
For more information on this testing software visit: http://impacttest.com.

Thursday, January 20, 2011

Concussion Recognition Training for Coaches of 11-18 Year Old Athletes in Colorado

On January 13, 2011, SB11-040 was introduced into the Colorado Senate by Sen. Nancy Spence (R-Centennial).  The bill, named the “Jake Snakenberg Youth Concussion Act,” was named after Jake Snakenberg, a freshman football player at Grandview High School who died in 2004 as a result of a concussion.  As currently written, SB11-040 requires coaches who deal with 11-18 year old athletes in Colorado schools, private sports clubs, and recreation centers to attend annual concussion recognition courses.  It also requires coaches to remove the player from the game, competition,  or even practice if they suspect that the young athlete has sustained a concussion.  Finally, the bill limits the liability of the coach unless his acts or omissions were grossly negligent, willful, or wanton, and completely shields any liability for board of directors or governing boards for the school districts, private clubs, or rec facilities for their coaches’ conduct.
The course is scheduled to be a 30-45 minute online course that will be offered for free statewide.  The measure will likely get its first public hearing late this month or early next month.  It has both Republican and Democratic sponsors in the State House as well as the Senate.
It will be very interesting to watch this bill as it progresses, and whether any opposition will be made because of the limited liability it proposes to those individuals we, as parents, entrust to keep our children safe during sports play.  We will continue to monitor this bill and post any relevant updates as they arise.  The complete bill, as introduced, together with the bill’s history can be found at: http://www.leg.state.co.us/clics/clics2011a/csl.nsf/fsbillcont3/A9CE9CEE12645CAA8725780800800D80?open&file=040_01.pdf 

Friday, January 14, 2011

Gunshot Wound Traumatic Brain Injuries

With the nation’s focus on the tragic incident that happened to Congresswoman Giffords in Arizona, concern for her recovery has everyone interested in general about traumatic brain injuries caused by gunshot wounds.  Statistically, about 90% of individuals who are shot in the head die, but most die within the first couple of days.  Of those that survive, lasting deficits depend on the area or areas of the brain that were affected by the shooting.  One key treatment for survival of such a traumatic injury is to remove a portion of the skull to eliminate pressure on the brain from its swelling after the injury.  The swelling typically continues for about five days and is usually the worst on the third day after the injury.  A second treatment is to place the patient in a medically induced coma, which limits brain activity, so that the remaining brain cells can have a chance to repair themselves.  Patients are also put on a respirator to keep the brain cells bathed in oxygen, which is needed for cell recovery.
Once the initial survival hurdle is overcome, the patient is still at risk for seizures and infection, so medications are given early on to prevent both.   Severe brain injuries, such as from gunshot wounds, can leave the victim with physical disabilities, cognitive problems, and behavioral symptoms.  The potential physical symptoms can run from total or partial paralysis to things like vision and speech problems, and general fatigue.  Cognitive and behavioral disabilities from a severe brain injury can pose devastating problems for the victim too.  There are innumerable cognitive and behavioral issues that a TBI victim may have to deal with, including attention, concentration, learning, and memory issues, as well as depression, irritability, and inappropriate behavior issues.  Recovery from such a devastating injury is very slow, and improvements can continue to be seen months up to several years later.  Some of the recovery is attributable to rewiring of neurons in the brain, sprouting new connections to attempt to regain their former functions and take over functions of the neurons that were lost.
Rehabilitation usually starts at a Brain Injury Program at an Inpatient Rehabilitation Hospital and then progresses to outpatient programs and working with support groups.  Finally, one of the most important parts of the rehabilitation process is family understanding and support for the TBI victim.  Dealing with the effects of TBI is a lifelong issue for the family, as well as the victim.

Tuesday, January 11, 2011

DHA May Play A Neuroprotective Role for TBI Victims

A study by Researchers from the West Virginia University School of Medicine, with colleagues from Columbia, MD-based Martek Biosciences, published in the February issue of Neurosurgery, official journal of the Congress of Neurological Surgeons, states that taking the omega-3 fatty acid docosahexanoic acid (DHA) might offer a new way of protecting against traumatic brain injury (TBI). This omega-3 fatty acid is widely available from an algae or fish oil source.

Even though the study warns the results are preliminary, the results raise the "intriguing" possibility of preventive treatment with DHA in groups at high risk of TBI, such as military personnel and athletes in contact sports—including football players. In the study, rats were treated with DHA at varying doses, equivalent to those used in humans taking DHA supplements. After one month of treatment, tissue and behavioural responses to induced TBI were compared between groups of treated animals. The tissue damage caused by TBI was significantly reduced in rats taking the highest dose of DHA: 40 milligrams per kilogram of body weight. Cellular findings included a significant reduction in expression of a protein (beta amyloid protein) that has been implicated in the development of Alzheimer's disease.

Additionally, animals receiving the highest dose of DHA before TBI also had reduced expression of key indicators of brain cell death (caspase 3 and macrophages). The DHA-treated rats also performed better on a test of spatial memory, indicating less behavioural impairment.

These studies add to recent evidence suggesting that DHA may be the first treatment of any type to reduce brain tissue damage caused by TBI.

While more research is necessary, another pending study at the University of North Carolina at Chapel Hill is looking at whether DHA affects long-term brain function in retired National Football League players. This is certainly an important subject to keep appraised of as research continues in this area, and we will continue to report any new developments.

 
Read entire journal article: http://journals.lww.com/neurosurgery/Fulltext/2011/02000/Dietary_Supplementation_With_the_Omega_3_Fatty.31.aspx

Thursday, January 6, 2011

New Concussion Detection Device in Development

Researchers at the Greensboro Joint School of Nanoscience and Nanoengineering in North Carolina are in the process of developing a device that would use blood, saliva, or a urine sample from a person to detect if a person has sustained a head injury.  A chip will sense the presence of compounds in the body that the brain releases when it's injured.  The test is one that could be done quickly on the scene of an auto accident, on a ski slope, or even on a football field.  Researchers hope to have a prototype of the detection device by the end of 2011.  This is truly a great advancement for Traumatic Brain Injury victims, because the sooner a brain injury is detected, the more effective treatment can be for the injured victim. 
 http://sports.espn.go.com/action/freeskiing/news/story?id=5985987

Wednesday, January 5, 2011

Welcome!

Welcome to my blog!  As an attorney who has handled traumatic brain injury cases for more than 25 years, and as the mother of a traumatic brain injury victim, I understand that each brain injury is unique, not only in terms of the victim’s symptoms and prognosis, but also for the effect is has on the victim's family. I have devoted my law practice, Nelson Law Offices, LLC, to helping traumatic brain injury victims throughout Colorado. In my practice I am passionate about getting these victims the help and compensation that they deserve. In doing so, it is important to keep on top of what is happening in this field.  Therefore, this blog will provide up to date general information on traumatic brain injuries as well as any new developments for detection, prevention, and treatment.