Injuryboard Commentary - brain Injury

Managing Brain Injury - new Guide now available from the National Rehabilitation Hospital

Doug Landau — Wed, 02 Dec 2009 00:26:00 GMT

In his continuing efforts to help those with traumatic brain injury and disabled from head trauma, Herndon Reston lawyer Doug Landau receives and reviews materials from the National Rehabilitation Hospital ("NRH"), Brain Injury Services, the Brain Injury Association and the Virginia Trial Lawyers Brain Injury Retreat. The NRH Press latest book offering is "Managing Brain Injury: A Guide to Living Well with Brain Injury."

This is the 4th book in a series of useful guides to help people face the challenges of life following brain injury. As Landau and the ABRAMS LANDAU trial team has worked with many victims of traumatic brain injury ("TBI") and closed head injury, they understand the importance of having resources such as this available for disabled clients and their families. This new NRH guide is intended to help make sense of the roller coaster ride of emotional and physical changes that can overwhelm patients and health care providers. To order this helpful book, visit NRH Rehab or call 202-877-1776

Originally posted at InjuryBoard by Doug Landau

Advanced Technology Showing How PTSD Alters Brain Function

David Mittleman — Sat, 28 Nov 2009 16:22:42 GMT

For years people suffering from post traumatic stress disorder (PTSD) were dismissed as complainers and fakers. Their cases were given little to no serious consideration from the medical community and from society at large. Slowly, that has started to change. As our National News Desk at InjuryBoard highlighted, PTSD is now listed in the diagnostic manual used by psychiatrists and psychologists along with the criteria for making the diagnosis.

Up until now, however, PTSD has largely been diagnosed through its symptoms without a significant method of objectively testing just how the mind has been affected by the traumatic events that led to the disorder. That is slowly starting to change. New and powerful imaging tests are being developed to detect just how the brain changes in people with PTSD. The disease that was once "just in your head" is turning out to be the result of damage to the brain's nerve fibers that handle memory and confusion.

The technique is called Diffusion Tensor Imaging. It is a non-invasive procedure adds just a little time to a standard MRI. It involves tracking how water flows through tiny, celery stalk-like nerve fibers in the brain, measuring the direction and speed of the water molecules to determine if the nerve fibers have suffered any damage.

While this research has been primarily driven by the waves of veterans from Afghanistan and Iraq who has suffered from PTSD and Traumatic Brain Injuries (PDF), the ramifications of this technology can be far reaching. Countless Americans suffer from PTSD and traumatic brain injuries, ranging from an auto accident to surviving traumatic events such as a rape or child abuse. Treatment for all these individuals will likely be altered from this research as scientists learn more about how the brain heals itself from traumatic events.

Originally posted at InjuryBoard by David Mittleman

I-35 Texas Car Accident Involves a Cyclone and a Hawkeye Football Player

Steve Lombardi — Thu, 26 Nov 2009 10:33:13 GMT

David Cato, 19 who plays defensive back for the Iowa Hawkeyes and Ter’ran Denton, (sic) 19 a defensive back from the Iowa State Cyclones were driving on I-35 south of Purcell at 10:00 a.m. on a Sunday when the car they were in rolled after coming in contact with a semi-truck. According to the news report the trooper has the 18-wheeler being nudged before rolling and striking the embankment on the west side of the Interstate Highway.

Both Cato and Denton were wearing seatbelts. Both required medical care and treatment. It appears the most seriously injured was Denton, the Iowa State Cyclone, who was transported to the Norman Regional Hospital for a head injury. There is no indication if he suffered from traumatic brain injury or how serious and extensive his head injury.

David Cato is listed on the Iowa Hawkeye Football team roster as a sophomore defensive back from Arlington, Texas. He is listed as second on the depth chart behind Sash.

David Cato

So.

5-11/205

Arlington, TX (Summit)

Ter’ran Benton is listed on the Cyclones roster as also from Arlington, Texas and a defensive back in his sophomore year. The roster has his last name as Benton not Denton.

Benton, Ter'ran

6-0

197

So.

Arlington, Texas (Summit)

Read Lombardi on The Verdict.

Hawkeye Cato and Cyclone Benton involved in I-35 Collision in Texas...
Posted on 11/26/2009

I-35 Texas Car Accident Involves a Cyclone and a Hawkeye Football Player

Originally posted at InjuryBoard by Steve Lombardi

NFL Concussion Policy: a Very Slow Work in Progress

Michael Phelan — Tue, 24 Nov 2009 14:36:43 GMT

With every new round of concussions in the NFL, it seems to me that the press and the NFL react as if dangerous concussions were a new issue in football. The multitude of stories about the brain damage, alzheimers-like symptoms, memory loss, depression, and suicidal behavior of former players like Andre Waters, Mike Webster, Tim Johnson and others get swept under the carpet as the NFL takes its predictable stance of delay and double talk on the issue of brain injuries. And, with the exception of the New York Times series on brain injuries in the NFL, the sports media typically looks the other way. Until now. Sports Illustrated's Ann Killion has written a piece in her Inside the NFL column accusing Commissioner Roger Goodell of business as usual just as he announced a new policy requiring teams to consult with independent neurologists following a concussion to one of the teams' players.

Ms. Killion cites the cases of the two quarterbacks who played in last year's Super Bowl. The Steelers' Ben Roethlisberger left Sunday's game against the Chiefs after taking a blow to the head and suffering concussion-like syndromes. But by Monday reports out of Pittsburgh described the Super Bowl winning quarterback as "fine" and capable of playing this week. Arizona's Kurt Warner also left his game against St. Louis after his head slammed into the turf. But the Cardinals are "optimistic" Warner will play this week. This, despite the fact that Big Ben suffered a serious head injury in a motorcycle crash and Warner suffered multiple concussions in the past. Ms. Killion concludes that "[t]he culture of denial and quick turnarounds runs too deep in the NFL to be changed by a commissioner's mandate."

This SI column follows a recent article in The New Yorker, in which Ira Casson, who co-chairs an NFL committee on brain injury, said he isn't sure what the solution is. "No one has any suggestions -- assuming that you aren't saying no more football, because let's be honest, that's not going to happen," he said.

Commissioner Goodell's new policy addresses an issue that has long been part of the problem in the NFL: the onflict of interest posed by leaving the decision about when a concussed player should return to full contact to a doctor employed by the team and the league.

Ms. Killion points out that the culture of denial trickles down to college, high school and youth football. Every day, coaches and administrators struggle with medical issues far beyond their capability. At Cal, Jahvid Best has been sidelined for two weeks after suffering a horrific end zone collision and concussion. In Florida, Tim Tebow -- who, in September, was knocked out cold and carted off the field vomiting -- hasn't missed a game (the Gators had a bye the week after Tebow suffered his concussion). But some observers think he hasn't been the same since.

On high school fields around the country, kids are carted off with concussions every week. In New Jersey last year, a junior linebacker was cleared to play after suffering a concussion. He suffered another hit, which ended up killing him. His parents are suing the high school and their doctor.

The violent hits are celebrated. The early returns to the field are deemed courageous. The head traumas of star players are underplayed.

The NFL sets the tone for it all. Commissioner Goodell took a step forward this week. But there's a long way to go.

Originally posted at InjuryBoard by Michael Phelan

Coping with Brain Injury During the Holidays

Michael Phelan — Mon, 23 Nov 2009 21:06:03 GMT

For victims of acquired brain injury, the time of year that once brought great joy may now be the most difficult time of year. Brain injury victims often struggle to cope with, among other sequelae, memory problems, obsessive compulsive behaviors, an aversion to loud noises, big crowds, and bright lights, decreased communication skills, and special diets. Imagine the terror of tying to cope with these issues while being expected to attend holiday parties and large family functions.

I read a wonderful piece in the Augusta Free Press advising brain injury victims how to cope with the holidays. Some suggested ways for making the holidays fun and less stressful for all, particularly when persistent cognitive /behavioral issues are problematic include:

1. Holiday shopping should be a fun activity and indoor malls are weather controlled and safe places for strolling on foot and/or for those wheelchair or walker assisted. However, the holiday period can make shopping less than a fun activity without preplanning. Start early to avoid the holiday crowds and use the opportunity to incorporate cognitive exercises into the planning. The individual with brain injury should make a list of gifts to be purchased or hand made, when possible, suggested gift ideas and estimates of costs associated with the gifts.

2. Catalogs that come in the mail this time of year are wonderful for gift ideas and also for estimation of prices. Take some time to sit down and look through a few as part of the independent planning phase.

3. Make out a simple budget before going to the bank and allow your family member with brain injury as much control of the funds as possible even though money management skills may be impaired.

4. Place greater emphasis on use of journals or calendars to record routine events as well as holiday activities. Schedule a week in advance, with a daily review to make note of any changes as they come up. Those accustomed to a daily routine may be better prepared when special dates and activities are written in the journal and/or on the calendar in colored ink for emphasis.

5. Each day, during the holidays, orient the individual by discussing the day’s activities over breakfast to avoid misunderstandings about changes from the normal routine. It is helpful to repeat this information several times during the day for those with severe memory problems.

6. If bright or flashing lights bother your family member and/or possibly trigger seizures, carefully plan any additional lighting that will be used during the holidays and avoid laser holiday lighting displays.

7. Crowded places and loud music may also bother some individuals and should be taken into consideration and monitored, if necessary.

8. Food is a big part of holiday fun and many of the foods may be very temptingly displayed. Parties, holiday family dinners, and open house gatherings are often scheduled at times that do not coincide with routine mealtimes, thus, presenting a problem for those whose mealtimes are more rigidly scheduled. You may want to offer a light snack at the regular mealtime to “tide him/ her over” until the main meal, or make whatever adjustments are necessary. For those with more severe cognitive deficits, which interfere with appropriate food intake, it may be necessary to help with monitoring to avoid overeating. It is very common for damage in the hypothalamus area of the brain to interrupt signals to the brain which help the individual know when their appetite has been satisfied, thus, many with brain injury need help with quantity control monitoring. Additionally, memory problems and attention can derail a persons resolve to watch their food intake to avoid excessive food and beverage intake. After a brain injury burning of calories may also be changed and individuals who could eat anything and everything before the injury may need to more diligently watch calories to avoid weight gain.

9. By all means don’t forget that increased activity during the holidays may be more fatiguing than usual so plan rest periods accordingly. This is particularly important when cognition and behavior are problems. Fatigue often increases confusion that can result in an outburst or other kinds of unpleasant behaviors.

10. Structure can be your best strategy for ensuring the entire family has a higher quality of life. Initially it takes effort to get the structure in place but it pays dividends in the end. Flexibility is a key word during the holiday season but planning and preparation will hopefully result in a happy holiday for family and friends.

Next comes New Year’s resolutions! Start thinking about ways your entire family can enjoy life more fully, fulfill the demands of your caregiving role and provide the best possible quality of life for your family member with brain injury.

Most of us take these simple pleasures for granted. As the father of a young adult with who suffers from the effects of brian injury and someone who represents victims of acquired brain injury, I know the importance of structure and routine in my child's life. There's nothing like the holidays to disrupt this routine.

Originally posted at InjuryBoard by Michael Phelan

Time lost is brain lost after a stroke

Doug Landau — Sat, 21 Nov 2009 00:17:00 GMT

With a stroke, time lost is brain lost

This was the crux of a notice Ashburn, South Riding and Broadlands brain injury lawyer Doug Landau received in Charlottesville, Virginia. The Stroke Association wants people to know that:

strokes are the #3 killer in this country, yet many people don't even know what they are. They don't know that more of the brain can be saved if a stroke is detected and treatment is received immediately. Strokes begin when a blood vessel in the brain becomes blocked or bursts. Blow flow is cut off. Tissue is starved for oxygen, and parts of the brain die. If not treated quickly, abilities and productive life can be lost. Learn to spot the warning signs of a stroke or call 1-888-4-STROKE, and act quickly. Your brain is your most prized possession. Guard it with your life.

Originally posted at InjuryBoard by Doug Landau

What to Expect if Your Child Has a Traumatic Brain Injury

Rick Shapiro — Wed, 18 Nov 2009 18:44:41 GMT

As a parent you do everything in your power to protect your child from harm, but what do you do if your child is hurt while at school or daycare? No parent can be expected to keep a constant vigil on their child and they have to put faith into the hands of professional caregivers. Most of the time no harm comes to a child under the supervision of a licensed caregiver, but children can still get hurt. If your child suffered a traumatic brain injury due to someone else’s negligence you will want to know what to expect.

How to Cope After A Child's Brain Injury

Injuries to children, especially involving the brain, can be more serious then similar injuries to an adult. Children’s bodies are still developing and a traumatic brain injury could cause life long disabilities in the child’s functions, movement, speech or thought processes. If your child is injured your first step is to seek medical care. Talk to a doctor that specializes in healing children, especially one experienced in brain damage/injuries. The specialties are neurology and neurological psychiatry. Discuss all of the facts regarding treatment options, surgery, and rehabilitation. Design a treatment plan for your child to address the brain injury.

What Happens During a Traumatic Brain Injury Lawsuit?

While it may be overwhelming, if your child was injured due to someone else’s negligence you may want to seek help from a personal injury lawyer, as it may be the only vehicle to exact responsibility from a careless or negligent person or caregiver. A personal injury lawyer can seek damages for your child to help pay for their recovery and will analyze the potentially responsible parties, and the insurance sources-a major issue in the analysis. If the brain injury claim is denied the injury lawyer may advise you on the merit of filing a lawsuit in your capacity as parent or guardian for the minor child or a severely harmed person over 18 who can not represent themselves. This is known as “guardian ad litem.”

The first stage of the law suit, known as “discovery,” (including the filing of interrogatories) is where each party will will pleadings and attempt to collect information about each other. During this period your lawyer may request your family’s medical records, bank statements, and seek out medical practitioners who can address your child’s brain injury. Depositions will also likely occur during this stage. A deposition is where a witness provides answers to relevant questions under oath, but read the links provided for more information about the lawsuit process.

During the discovery process, your child may be required to undergo an Independent Medical Exam, or IME an evaluation about the extent of the brain damage/injury. In the IME the doctor is chosen by the other parties’ lawyers and any information collected can usually be used in the lawsuit.

Our law firm may adopt many different strategies to best represent a brain damage/injury victim. We may shoot one or more short videos of the child relfecting damage to speech or motor functions they are suffering from. Medical illustrations, important evidence on graphics, all sorts of techniques are adapted by a competent brain injury attorney--but each case is different.

Traumatic brain injuries can be life altering and often require lengthy medical care--the economic impact of nursing and professional care alone requires what is called a qualified "life care plan" in many cases also. A competent injury lawyer handling such a case must be familiar with how to develop the life care plan, and should be familiar with such forensic experts as well as forensic rehabilitation experts as well.

About the Editors: Shapiro, Cooper, Lewis & Appleton personal injury law firm (VA-NC law offices ) edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard, and Northeast North Carolina Injuryboard as a pro bono service to consumers.

Originally posted at InjuryBoard by Rick Shapiro

Surprising Facts about Spinal Cord Injuries

Jim Lewis — Wed, 11 Nov 2009 00:10:00 GMT

According to www.sci-info-pages.com, a website of caregivers centred on spinal cord injuries, about 250,000 Americans have a spinal cord injury. A little over half, or 52% of spinal cord injured are paraplegic; an impairment in motor and sensory function of the lower extremities. 47% of the injured are quadriplegic; which is paralysis caused by illness or injury which results in partial or total loss of use of all the limbs and torso.

Vehicular accidents make up for 37% of the cause of spinal cord injury (SCI), followed by violent assault at 28%, falls are at 21%, and sports-related injuries amount to 6% of total spinal injuries. The majority of spinal cord injuries typically occur between the ages of 16-30 when an individual is usually the most physically active. This spinal trauma results in morbidity and also includes respiratory deficiency, bladder and bowel dysfunction and loss of motor and sensory functions. With the advent of these secondary complications from the initial spinal injury requires the patient to undergo physical and medical care for a longer period time.

Since motor vehicle accidents are the primary cause of spinal cord injury, the CDC has come up with safety measures to help prevent the occurrence of SCI. Also, it should be noted that you should never drive under the influence of drugs or alcohol for the obvious impairment issues related to such activity.

Originally posted at InjuryBoard by Jim Lewis

Head & Brain Injuries Should Not Be Overlooked

David Mittleman — Tue, 10 Nov 2009 16:56:19 GMT

Head injuries can happen any number of ways and can result in a number of different complications. Here are some early warning signs that may tell you if you have suffered from a head injury include:

Feeling dazed or having loss of consciousness, following with vomiting and nausea
Blurred vision
Headaches

Some more long term symptoms could include the following:

Irritability
Difficulty concentrating
Insomnia
Difficulty tolerating bright lights

Often, these symptoms are overlooked and frequently not recognized for head injury.

Minimize your chance of having a head injury by wearing helmets when engaged in activities where you could hit your head, such as skating, bike riding, etc. Wear your seat belt in your vehicle to prevent your head from hitting the interior of the car during an accident. Inspect your home for hazardous fall areas and do your best to make your home hazard free.

If you believe you or someone you care about may have suffered a head & brain injury do not hesistate to contact our office, ChurchWyble, at (888) 227-4770.

Originally posted at InjuryBoard by David Mittleman

Local Motorcyclist Exemplifies Fact that Helmets Save Lives

David Mittleman — Tue, 10 Nov 2009 12:34:49 GMT

I recently wrote about motorcycle accidents and the serious injuries they can cause. A logical and simple answer to increase motorcycle safety (pdf) is to wear a helmet while riding. A local man is a testament to this fact: Jimmy Hunter, a 56-year-old musician from Muskegon and a Harley-Davidson motorcycle rider, suffered a brain injury after he was in a car accident two years ago. However, his injuries would’ve been much worse if hadn’t worn a helmet.

Along with purchasing a Harley-Davidson Sportster, Hunter also purchased one of the best helmets available. In fact, it was a full-face helmet. Hunter admits he might have looked “silly” going down the road, but he readily adds that if he had worn a smaller helmet, he wouldn’t have survived. In fact, Hunter was injured after a vehicle pulled out in front of him, even though he was following the speed limit. Although the accident left him in critical condition for weeks, and he still has difficulty moving freely on his own, he continues outpatient therapy and hopes to ride his Harley again soon.

In Michigan, motorcycle deaths have increased slightly, from 124 in 2007 to 127 in 2008. While deaths are up statewide, fatalities decreased in Ingham, Clinton, and Eaton counties between 2007 and 2008. Hopefully, the decline in deaths can be partially attributed to other riders who put safety first and wear helmets while riding their motorcycles. At least in Hunter’s case, his helmet saved his life.

Originally posted at InjuryBoard by David Mittleman