Brain Injury Lawyer - New York

Acute Hospital Care Following Severe Brain Trauma

The miracles of modern medicine continue to save the lives of more and more individuals who have sustained severe brain injury.

How to best manage the care of a patient with severe brain injury involves the intervention of a multiple medical specialties.

An article in this month's British Journal of Anesthesia entitled Traumatic Brain Injury: intensive care management discussed the multidisciplinary team led by neurointensivists, neuroanaesthetists, and neurosurgeons.  The aim of care is the avoidance of secondary injury, maintenance of cerebral perfusion pressure (CPP), and optimization of cerebral oxygenation.

The review discussed he intensive care management of severe TBI with emphasis on the specific measures directed at the control of intracranial pressure and CPP.

For more information on reading this entire article click here.

Congress Not Happy With NFL

Following Tuesday's hearing on the practices of the NFL disability plan, the New York Times reports that some members of Congress are considering remedial action.

It's been a long time coming, but something must be done to protect players who are continually rejected for long term disability benefits despite clear proof that they sustained a traumatic brain injury while playing in the NFL that has rendered them permanently disabled.

Here's what the Times reports based upon interviews with House members:

"Whether Congress will ultimately consider action, or whether the hearing served merely as its public relations warning to the league and union to improve a disability system that the panel depicted as drawn-out and draconian, remained unclear one day after the hearing. But three members of the committee reasserted in telephone interviews yesterday that they would consider legislation should they not see improvements to the treatment of retired players, of whom 317 received disability payments of about $63,000 apiece last year."

According to the chairperson of the House Judiciary Subcommittee on Commercial and Administrative Law,  Linda T. Sanchez,  further hearings are likely and legislative action is imminent unless the league become more responsive and fairer to its disabled players.

Read the full New York Times story by clicking here.

HBO Documentary: COMA

HBO has announced the broadcast of a new documentary exploring the world of COMA to be aired Tuesady, July 3rd (9:00-10:45 ET/PT).

COMA explores the mysteries of the injured brain and its ability to heal.   Giving voice to people whose quality of life and very existence have been threatened, the special goes inside a top U.S. medical facility for the treatment of head trauma and follows four coma survivors over the course of a year.

Reportedly, the director was given unprecedented access to the Center for Head Injuries at the JFK Medical Center in Edison, NJ.  She chronicles the emotional stories of four families for one year, looking through the eyes of their renowned physicians and neuropsychologists, led by Dr. Joseph Giacino and Dr. Caroline McCagg.   

First reports from NFL Congressional Hearing

The long awaited congressional hearing into the unfairness of the NFL player's disability plan was held today by House Judiciary subcommittee chaired by  Rep. Linda Sanchez, D-Calif. and some of the testimony given by retired players suffering from brain damage wasn't pretty. 

Testimony about lives shattered, homelessness, years of depression, memory loss and other conditions were given my many retired players.  These players also testified to the refusal of the NFL disability fund to grant them disability benefits despite overwhelming evidence of brain injury sustained while playing professional football.

Here are some of the things that were said at today's hearing:

The players from the '50s, '60s and '70s laid the groundwork for the popularity of the NFL, a billion-dollar industry, and should be treated better, lawmakers said.

"Perhaps there ought to be a legal solution," said Rep. Chris Cannon, R-Utah.

"We have a group that should be protected, but is not being protected," said Rep. Tom Feeney, R-Fla.

"What is even more troubling is that through projects such as NFL Films, the NFL continues to profit off those very same players who are denied benefits," said Rep. Linda Sanchez, D-Calif.

What is extremely troubling to me is the failure on the part of the league to even admit that there might be a problem with a plan that has refused to acknowledge player's brain damage and other physical injuries despite the overwhelming evidence presented to them.   

You can read a full report of today's hearing by clicking here.

Defective Chinese Tires Lead to Brain Injury

A roll over accident of an SUV in New Jersey which led to severe brain injury was allegedly caused by defective tires manufactured in China by  Hangzhou Zhongce Rubber Co. and sold through it's US distributer Foreign Tires Sales Inc.  A lawsuit for the brain injuries and for the wrongful death of the other two vehicle occupants was instituted in the Federal District Court in New Jersey.

Today, the National Highway Traffic Safety Administration issued a recall of all tires manufactured by this company.  The tires are used as replacements on pickup trucks, sport utility vehicles and vans. 

Apparently the tires lack a critical component which causes the threads to separate.

Over 450,000 defective tires are involved in the recall.

This is not the first instance where defective tires have caused brain injuries and wrongful death to vehicle occupants.  Vehicle roll over accidents caused by thread separation is the defect that led Firestone in 2000 to undertake one of the largest tire recalls ever in the United States, involving millions of tires.

Senate Committee to Consider TBI Act

The Traumatic Brain Injury (TBI) Act reauthorization continues to move forward in the Senate.

Reports are that the Senate Committee on Health, Education, Labor and Pensions (Senate HELP Committee) will begin work on S. 793, “Reauthorization of the Traumatic Brain Injury (TBI) Act,” tomorrow, June 27, 2007. 

Here are portions of a letter sent by the Brain Injury Association of America (BIAA) earlier this moth to to the Senate HELP Committee’s Chairman, Sen. Edward Kennedy (D-MA) and Ranking Member, Sen. Orrin Hatch (R-UT), urging prompt committee consideration of the bill and expressing support for the legislation.

“Reauthorization of this legislation is needed now more than ever, as increasing numbers of our Armed Forces are returning from combat with traumatic brain injuries. Many of these heroic service members will join the 5.3 million American civilians who live with a long-term disability as a result of traumatic brain injury. They urgently need the community supports, protection and advocacy available through the TBI Act, which is the only federal law that specifically addresses this major public health problem and provides a foundation for state and federal agencies to combat the nation’s leading cause of death and disability for children and young adults.”

The bill directs the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health to determine the incidence and prevalence of TBI with respect to all age groups, institutional settings, and special populations. Importantly, the agencies are also directed to identify common therapeutic interventions and comparative effectiveness in improving functioning, as well as the adequacy of existing measures of outcomes.

Hopefully, following committee action, the full Senate will take up the bill.

Similar legislation has been introduced in the House of Representatives, H.R. 1418, which was introduced earlier this year by the Co-Chairs of the Congressional Brain Injury Task Force, Reps. Bill Pascrell, Jr. (D-NJ) and Todd Platts (R-PA).

It's still not to late to contact your House member and Senator and urge them to reauthorize the TBI Act.

NFL Disability Plan Cleaning Up Their Act Before Congressional Hearing

On Tuesday, a congressional hearing is scheduled to examine the NFL Disability Plan and the obstacles it put in the way of brain injured players from obtaining disability benefits.

Their have recently been several notable court cases where the actions of the league disability committee charged with determining the eligibility for disability benefits have been severely criticized.  The center of criticism has been the plan's contention that they have unfettered discretion to overrule the determinations of treating physician's and neuropsychologist's that either a player indeed has a brain injury and/or that the brain damage took place while playing professional football. 

I have reviewed several cases where the league ignored the opinions of treating professionals and actually went out to find a professional to voice a contrary position which the league then accepted and denied the player his disability benefits.  This action which can only be characterized as mean spirited and contrary to due process has actually been condoned by the court's who claim they are powerless to rewrite the collective bargaining agreement between the players association and the league. 

It is my legal opinion that this agreement is contrary to equitable principles, due process and should be stricken by the courts as being unconscionable.

Now fearing Congress will act. the Washington Post reports that the disability plan is going to change how they look at the opinions of treating health care providers in some limited instances. 

If a player has been granted social security disability benefits, then that individual will automatically qualify for NFL disability benefits.  Under Social Security regulations, the opinions of treating health care providers are entitled to greater weight then the opinions of "hired guns" and due deference must be given to the opinion of the professional,  who presumably knows the injured applicant the best. 

I am hopeful that continued public pressure on the NFL players association and the National Football League will force these NFL disability plan to use the social security criteria in ALL disability cases, even before a decision is reached by the social security administration which could take years.

Why this plan thinks it is entitled to greater rights over injured individuals then even our government has in something that is truly troubling. 

You can read the full Washington Post story "Plan Eases NFL Disability Process" by clicking here.

Support the Brain Injury Association of New York State

Here's a simple way to support the Brain Injury Association of New York State.

GoodSearch, a yahoo-powered search engine will donate a penny per search to the charities its users designate.

Once you're in GoodSearch, just type in Brain Injury Association of NYS in the "who do you GoodSearch for?" section and press verify.  Each time you use GoodSearch, the Brain Injury Association of New York State will benefit!

NFL & Concussions--Where do we go from here?

Yesterday's NFL Concussion Summit did not produce any new results concerning the crisis of concussions in professional sports.  What it did do, however is spark renewed interest in the dangers of concussions and public awareness of issues surrounding mild traumatic brain injury. 

Mild traumatic brain injury is a true public health crisis and more attention needs to be focused on injury prevention, brain injury rehabilitation programs and supports for family members and  persons who have sustained this life altering injury.

The debate that took place yesterday in Chicago between those who refuse to accept the medical truth about concussions and mild traumatic brain injury and those whose only true interest is the health and safety of the players needs to move forward.  While more research certainly needs to be done, the large body of medical research that now exists certainly supports the need for firm rules requiring players who have sustained a concussion or a suspected concussion to sit out the rest of the game and not be allowed to return to play until both their cognitive difficulties and physical difficulties have cleared.  Anything less than that is certainly unacceptable.

The league needs to change it's disability plan and provide needed benefits for those players who have sustained mild traumatic brain injuries.

I look forward to participating in these discussions and working with those concerned about players and the bigger picture of the management of concussions in sports.

You can read more about the concussion conference and the debate by clicking here.

NFL Concussion Summit Today

Following heated criticism of the National Football League (NFL) and their policies of concussion management, a concussion conference is being held today in Chicago.  The league has mandated that all teams send their medical representatives including doctors and trainers to discuss the important issues pertaining to concussion management.

The league as already instituted some important changes including requirements of baseline off season testing neuropsychological testing of all players and protection for those players who blow the whistle on coaches who ignore the health and safety of their players. 

I am hopeful that this conference will produce some further needed changes including mandatory time periods that players must be side lined before being allowed to return to play, I suggest that at a minimum, a player NEVER be allowed to return to play in the same game in which they had a concussion or a suspected concussion.

Further, following several concussions, a player should be required to undergo PET Scan study and other cognitive testing.  If the results of this testing shows, brain damage, then they should face mandatory retirement. 

The league must set up educational programs to alert players and their families about the subtle and hidden signs of concussions and the life long consequences of this injury.  Further, I am hopeful that the league will use some of their enormous profits to educate high school and college athletes about the dangers of repeated concussions.  Brain Injury prevention programs is something that the league needs to take an active part in.

For a comprehensive story on this conference and the background of how the NFL has dealt with concussions, read today's USA Today article, Concussions command NFL's attention in which I am quoted.

Head Injury State Administrator's Conference Announced

The 18th ANNUAL STATE OF THE STATES IN HEAD INJURY CONFERENCE has been scheduled for September 5-8, 2007 to be held this year at the Adam's Mark Hotel, St. Louis, Missouri

The State of the States in Head Injury Conference is the only annual national meeting providing professional development opportunities among state government program administrators in the field of traumatic brain injury.  The conference will feature keynote speakers who will present on Federal legislation and policies impacting TBI and state services, national trends, and cross-cutting issues.  Of particular interest of TBI Advocates will be the status and visibility of the TBI Act Reauthorization legislation and FY 2008 appropriations for Federal TBI Programs.

The Pre-conference, Seamless Transitions…Supporting our Veterans and Families will focus on the needs of veterans with brain injury and resources available to them.  Click this link to Register.

Brain Injury Association Receives Award For Web Based School Learning Program

Congratulations to the Brain Injury Association of New York State (BIANYS) for an award received in the amount of $150,000 from the New York State Developmental Disabilities Planning Council (DDPC) to establish and sustain a web-based resource for families and school district personnel working with students with Acquired and Traumatic Brain Injury (ATBI)

The award is intended for the establishment and to sustain a web-based resource for families and school district personnel working with students with Acquired and Traumatic Brain Injury (ATBI.) The Brain Injury Association of New York State (BIANYS) is a statewide non-profit membership organization that advocates on behalf of individuals with brain injury and their families, and promotes prevention. Established in 1982, BIANYS provides education, advocacy, and community support services that lead to improved outcomes for children and adults with brain injuries and their families.   I have been honored to have served three terms as president of the Brain Injury Association of New York State.

BIANYS and the DDPC recognize that successful life transitions for students with ATBI requires very specific knowledge and awareness of brain injury. It was also well established that teachers and parents do not have enough resources to address the needs of students with ATBI.

This grant will develop a sustainable website called Project LEARNET that can be utilized by parents and teachers as a resource when looking for the best solution to a variety of problems involving students with brain injuries. During the next year, BIANYS will focus on marketing the website with government agencies and professional agency partners such as the State Education Department, school districts and families.

More Evidence of the Dangers of Multiple Concussions in Professional Football

More medical evidence establishing the link between repeated concussions and permanent brain damage has been reported in today's New York Times.

The Times reports that Dr.Omalu, the neuropathologist who first reported finding evidence of persistent brain damage on autopsy examination of the brains of retired football players has now confirmed a fourth case.

Dr. Omalu examined the brain of  former Pittsburgh Steelers offensive lineman Justin Strzelczyk, who died at age 36 following a car accident.  Before the accident, Strzelczyk was suffering from depression, mood swings and memory difficulties which related back to the multiple concussions and head trauma that he sustained in his years playing professional football. 

Strzelczyk is the fourth former National Football League player to have been found post-mortem to have had a condition similar to that generally found only in boxers with dementia or people in their 80s. The  condition is known as chronic traumatic encephalopathy and has been established in the brains of boxers subjected to repeated brain trauma. The diagnosis was made by Dr. Bennet Omalu, a neuropathologist at the University of Pittsburgh Medical Center. In the past five years, he has found similar damage in the brains of the former N.F.L. players Mike Webster, Terry Long and Andre Waters. The finding will add to the growing evidence that longtime football players, particularly linemen, might endure hidden brain trauma that is only now becoming recognized.

Omalu is quoted in the Times article as saying,  “This is irreversible brain damage,” “It’s most likely caused by concussions sustained on the football field.”  Omalu's findings have been backed up by other physicians who were asked to consult on this matter.

A great deal of credit for this continued investigation must go to Christopher Nowinski,  a former Harvard football player who retired from wrestling because of repeated concussions in both sports.  He is the author of a great book entitled, Head Games--Football's Concussion Crisis and has become an outspoken critic of how professional sports handles the issues related to repeat concussions and when to allow players to return to play.

Nowinski has teamed up with Dr. Omalu as well as with Dr. Julian Bailes, the chairman of the department of neurosurgery at West Virginia University and the Steelers’ team neurosurgeon during Strzelczyk’s career to form an organization, the Sports Legacy Institute, to begin conducting more formalized research.

“We want to get a idea of risks of concussions and how widespread chronic traumatic encephalopathy is in former football players,” Nowinski said. “We are confident there are more cases out there in more sports.” according to the Times. 

Next Tuesday, the NFL Mild Concussion Committee has scheduled a meeting in Chicago to discuss head trauma in the NFL.  The NFL continues to resist the mounting evidence of the link between head trauma, concussions, depression and other psychiatric conditions as well as early onset Alzheimer's Disease. I am hopeful that they begin to seriously address the issues raised by Dr. Omalu's findings.

You can read the full Times story by clicking here.

Traumatic Brain Injury Training Program

I have been asked to post this announcement sent by Dr. Janis Ruoff, Director of the Center for Education and Human Services in Acquired Brain Injury at George Washington University:

I'm happy to announce that the George Washington University (GW), Department of Teacher Preparation and Special Education (DTPSE) has received a new 4 year personnel training grant from the Office of Special Education Programs (OSEP) for the master’s degree in transition special
education: emphasis in acquired brain injury.  The grant will provide tuition support (80%) for all accepted students and also includes direct stipends for students to assist them with class related expenses, travel for internships, and travel to professional conferences.  For further information, please contact Zavolia Willis (Zee)  or at (202) 973-1082. We are currently accepting applications for fall 2007 and spring 2008.

This new grant supports the training of teachers for initial licensure with a specialization in serving students with traumatic brain injuries (TBI) and includes a combination of on campus and distance education coursework.   A specialized brain injury internship and a one semester student teaching experience are also required.  The program has been nationally ranked and accredited by the National Council on Accreditation of Teacher Education (NCATE) and the Council for Exceptional Children (CEC).

GW also offers tuition support,  through another OSEP grant, for graduate students in our Graduate Certificate in Special Education and Brain Injury for anyone who would like to add that coursework as a specialized niche within their field.  For more information about that program, inquires may be directed to Monija Amani  or (202) 973-1032.

For information about applying to either of these programs, please visit our Graduate School of Education and Human Development (GSEHD) web site and use the Apply On-line application process. 

Head Injury and Stroke Increase Risk of Alzheimer's Disease

Recent studies have shown that the risk of Alzheimer's disease is increased following a head injury. 

Now researchers have determined the mechanism for this increased risk.  They have determined that following the death of brain cells after a stroke or head injury, levels of a protein known as amylois-beta increase causing the formation of plaque on the victim's brain.

It's hoped that future medical research will develop a way of preventing the release of this hormone.

The current study has great implications for boxers, football players and others who have sustained repeated head injury.  Each such injury increases the formation of plaque and adds to the risk of future development of Alzheimer's disease.

The study is published in the journal Neuron. Depletion of GGA3 Stabilizes BACE and Enhances Beta-Secretase Activity. Volume 54, Issue 5, 7 June 2007, Pages 721-737

VA To Screen All Returning Veterans for Brain Injury

The associated press reports that all soldiers returning from Iraq or Afghanistan who seek any treatment at Veterans Affairs hospitals are now being screened for brain injuries and post-traumatic stress disorder according to  VA Secretary Jim Nicholson.

What troubles me however, are the countless soldiers who are not being screened because they have not accessed the VA medical system for any type of care.  We all know that many individuals suffering from the post concussion syndrome do not seek care and are not even aware that their symptoms and condition is the result of a brain trauma.

It would make sense to me that in addition to screening done at the VA clinic, ALL vets returning from Iraq be screened regardless of whether or not they are seeking any medical treatment.  It is only through this comprehensive screening that the post concussion syndrome will be timely diagnosed and timely treatment undertaken to assist these individuals.  Anything less is simply ignoring the bigger problem of traumatic brain injury and the number of soldiers plagued by this condition.

CDC Updates Definition of Concussion and Mild Traumatic Brain Injury

The Centers for Disease Control and Prevention has revised educational materials for physicians treating concussions and mild traumatic brain injury, terms that the CDC says are interchangeable.   As part of their revision they have updated the definition of concussion to reflect current medical opinion.

The CDC defines Concussion  or mild traumatic brain injury as follows:

Definition of Mild Traumatic Brain Injury (MTBI): The term mild traumatic brain injury (MTBI) is used interchangeably with the term concussion. An MTBI or concussion is defined as a complex pathophysiologic process affecting the brain, induced by traumatic biomechanical forces secondary to direct or indirect forces to the head. MTBI is caused by a blow or jolt to the head that disrupts the function of the brain. This disturbance of brain function is typically associated with normal structural neuroimaging findings (i.e., CT scan, MRI).

MTBI results in a constellation of physical, cognitive, emotional and/or sleep-related symptoms and may or may not involve a loss of consciousness (LOC). Duration of symptoms is highly variable and may last from several minutes to days, weeks, months, or even longer in some cases

"Heads Up: Brain Injury in Your Practice" is a multimedia toolkit the CDC gives physicians to help provide earlier diagnosis, management and appropriate referral for patients with concussions.

A key component of the revised kit is an assessment guide to help physicians recognize a concussion earlier.

The physicians' kit contains easy-to-use clinical information tools, including facts about concussions, how to prevent them, a palm card for on-site management of sports-related concussions and a CD with downloadable materials and additional resources. It can be ordered for free from the CDC,

Concerns Grow Over Missed Brain Injury Diagnosis in Returning Vets

There is increasing concern that many returning Iraq veterans are being misdiagnosed with post traumatic stress disorder when the real cause of their problems is post concussive syndrome as a result of brain damage sustained.

Many of the symptoms of post traumatic stress disorder (PTSD)  and post concussive syndrome overlap and mimic each other.  Because many Veterans have suffered from closed head brain injuries that are not apparent from visual observation or even from radiological studies, they are frequently misdiagnosed as suffering from some type of PTSD instead of a traumatic brain injury (TBI).  The delay in proper diagnosis impedes brain injury rehabilitation of these survivors and has serious repercussions for a good outcome.

New York's Senator Clinton has proposed neuropsychological screening of all returning Vets to determine if they sustained a TBI.  A good idea that needs to be enacted without delay.

For an interesting story on the problems of misdiagnosis of traumatic brain injury in returning Iraq vets, read the article from the Boston Globe by clicking here.

Congress to Hold Hearings on NFL & Concussions

Several months ago I was the first to call for a congressional inquiry into the way that the National Football League manages concussions.  Thankfully, congress has now heard from enough advocates on behalf of brain injury survivors that the first congressional hearing has been announced.

The House Judiciary Subcommittee on Commercial and Administrative Law has scheduled an oversight hearing on June 26 to look into the way benefits are paid to disabled former players.  They also intend to look into the NFL disability plan and the way that it determines disability benefits to players claiming a brain injury.

Here is what the Washington Post reported today:  The issue of disability payments has been contentious for several years but has only recently received much public attention as former players have stepped up to say they believe the pension and disability plan, managed in part by the NFLPA, routinely denies benefits for injuries suffered while playing in the NFL. Among the accusations is that the plan's administrators have created a system that makes it almost impossible for a player to claim disability.

"The NFL is a billion-dollar industry and yet the players who built the league are too often left to fend for themselves," Rep. Linda T. Sanchez (D-Calif.), who chairs the committee, said in a statement last night.

"The subcommittee has seen recent reports that the benefit plan offered to retired players may be stacked against players who need serious medical care."

Although lead officials and the head of the NFL players association have been invited to the hearings, they have not yet accepted this invitation and have not issued any comments about this inquiry.

You can read the full story in the Washington Post by clicking here.

NFL Concussion Studies Are Suspect

The New York Times has released a story to be published in Sunday's edition disputing the conclusions of a previously published NFL study in the Journal NeuroSurgery concerning the propriety of allowing high school and college players to return to play following a concussion.

Reportedly, two of the study authors dispute the conclusions contained in the study and have stated to the New York Times that they never approved of the final study conclusions.  This is quite shocking and calls into serious question the propriety of all the NFL studies on concussions and the prior statements of their concussion commission "experts", Drs. Pellman, Casson and Viano. 

Quite frankly, although I have read a great deal of literature in the area of sports concussions and have participated in many programs and seminars, other than the participation of these individuals with the NFL, they are no where to be seen. When I had invited Dr. Pellman and the NFL to participate in the concussion symposium that I had chaired on behalf of the Brain Injury Association of New York State at Madison Square Garden, they refused to attend and participate. 

Here's portions of what the unbelievable story the New York Times has published:

For several years, many medical experts have maintained that high school football players who sustain concussions should not return to the games in which they are injured. So when doctors commissioned by the National Football League published a study two years ago concluding “it might be safe” for such players to do so, the assertion sparked widespread criticism. Now the criticism is coming from authors of the paper itself.

Two of the five co-authors of the paper published in the journal Neurosurgery, Dr. Henry Feuer of the Indiana University Medical Center and Dr. Cynthia Arfken of Wayne State University, said in telephone interviews last week that the paper’s conclusion was inappropriate, and that the research should not be applied to high school and college players.

Arfken also said the passage had been added without her knowledge.

The two principal co-authors, Dr. David Viano of Wayne State and Dr. Ira Casson of Long Island Jewish Medical Center, acknowledged that they had altered the conclusion but said all authors had received proof copies before publication. They said the section in question was added to appease peer reviewers who asked for a discussion of high school and college players, and they continued to stand by what was written.

Arfken and Feuer disavowed the paper’s recommendation that high school and college medical personnel “keep an open mind” to the paper’s analysis of concussions, which deemed safe the league’s record of allowing half of the players with concussions to return to the same game. Arfken and Feuer thereby joined critics who have long claimed that that suggestion was dangerous for younger players, whose less-developed brain tissue is believed to be more susceptible to short- and long-term damage than that in adults, and who receive considerably less medical attention than players in the N.F.L.

Feuer said that he “would change that sentence; I’d eliminate it.” Regarding high school players, he added: “It’s been shown that they don’t seem to recover as fast. Period.”

The NFL has called a concussion for later this month. It's time that the NFL added some impartial and reputable individuals to their mild concussion committee.  I've volunteered to lend my expertise, but this has to date fallen on deaf ears.

While I have also communicated directly with Dr. Casson and NFL Commissioner for permission to attend this summit, they have denied my request.  Maybe they should reconsider and allow truly independent persons interested in brain injury safety and brain injury prevention to attend.

I look forward to hearing from the league and providing me with an invitation to attend this important gathering.

To read the full New York Times story entitled Two Authors of NFL Study Dispute Conclusion, you can click here.

Reminder: Brain Injury Association Annual Conference Featuring Bob Woodruff: Albany, June 7th and June 8th

Just a final reminder that the 25th Annual Conference of the Brain Injury Association of New York Sate is scheduled for this Thursday June 7 and Friday June 8 at the Marriott Hotel, Wolf Road, Albany, New York.  The response to this conference has already exceeded our expectations. Response to our program, including the keynote speaker, Bob Woodruff, has been overwhelming. With over 500 registered guests, for the first time ever, the association expects to have a sell out crowd. 

If you plan to attend the conference, register TODAY!  It's to late to register on line but you can the association office at  518 459 7911 to see if any space is still available.

I look forward to seeing as many of you as possible later this week in Albany, New York.  Please take a minute to say hello.

Safe travel

New Guidelines for Managing Severe Traumatic Brain Injury

The 3rd edition of the Guidelines for the Management of Severe Traumatic Brain Injury developed by the Brain Trauma Foundation are published in a special supplement (Voume 24 Supplement 1) of Journal of Neurotrauma. 

The first guidelines for the management of traumatic brain injury (TBI), developed by the Brain Trauma Foundation, became available in 1995 and emphasized the potential for improved outcomes by reducing or preventing secondary brain injury caused by hypoxia, hypotension, and intracranial hypertension during the critical hours and days after injury. The updated Guidelines reflect the cumulative evidence of human TBI studies published in the neurotrauma literature through March 2006. New topics include Hyperosmolar Therapy, Prophylactic Hypothermia, Infection Prophylaxis, Deep Vein Thrombosis Prophylaxis, Brain Oxygen Monitoring and Thresholds, and Anesthetics, Analgesics, and Sedatives.

The revised guidelines can be viewed free at the Brain Trauma Foundation web site.

Brain Injured Veterans Still Getting Short Changed

Despite all the talk in Washington about how the VA has changed their attitude towards brain injured soldiers, one has to really wonder after reading a story about Sgt Tyler Hall in today's Anchorage Daily News.

The news report chronicles the horrendous injuries that Sgt. Hall received in Iraq and the way the military continues to jockey to reduce his benefits.  Sounds to me like the VA is no better than most disability carriers in their attempts to reduce benefits following brain damage.

Sgt. Hall's multiple physical injuries include an amputation of his leg, and brain damage that resulted in his being placed in an induced coma for a month and a permanent shunt to drain fluid from his brain, Now, back in Alaska four years later, Tyler Hall still grapples with the effects of all that, from pain in his back and truncated leg to short-term memory loss that stems from brain damage.

With injuries so severe that the Dept of Defense initially listed him as dead and with current cognitive brain injuries that affect his speech and memory, the VA has reclassified his brain injury rating in half from a 100% disability to only a 50% disability.  This reduction in disability status makes him ineligible for home and community based assistance programs

As the story reports. "It would be different if he thought his brain injury was getting any better, Hall says, but he's pretty sure it isn't. He still wrestles with lapses in his speech and memory. He gets sharp headaches most days, just as he has for the past two years."

Here's the astounding response by the VA in Alaska: "Either the condition improves or the condition worsens," Scheibel said. "So we set up future exams for those kinds of conditions."  Do these bureaucrats ever consider that maybe the condition just stays the same or that the brain injury and it's disability continues but just affects the brain injury survivor in different ways.

Here's what his mother says,  "But this is not my son that I sent over to Iraq. He looks real similar, but he doesn't have the same nose. He doesn't have the same features. He has a brain injury. ... He went in (to the Army) with an attitude, and he came out with a completely different attitude."

Sadly those suffering from the life long consequences of traumatic brain injury still are not getting the attention and compensation they deserve.

You can read this full story by clicking here.

Concussion Assessment

A threshold issue in discussing sports related concussions, is the assessment of the individual following a concussion or a suspected concussion.

The big question in this area is what tests to use.  The most recent consensus published in the June issue of neurosurgery-online is that a combination of assessment tools be utilized.  Starting in the off season, all players need to have a base line neuropsychological assessment that can be utilized for comparison purposes after a concussion or suspected concussion takes place. 

Following the concussion, assessment tools should include:

• a self report of concussion symptom profile, typical questions are related to the post concussion syndrome symptoms of headache, dizziness, nausea, vomiting, memory problems, concentrations difficulties, sensitivity to sound or light,feeling in a "fog", feeling "slowed down", trouble falling asleep, drowisness ;
• an assessment of postural control;
• repeated tests of neurocognitive functioning

The consensus concludes that when used in conjunction with clinical examination the combined sensitivity of this testing in assessing concussions ranges from 89% to 96%.

Thus, in evaluating concussions or suspected concussions in athletes, it is important for those doing the evaluation to use ALL of these tools together. 

You can read the entire study on line "Sensitivity of the Concussion Assessment Battery"