The following webinairs are sponsored by the Brain Injury Association of America duing the month of July:
July 18, 2013, 3 p.m. ET, Mitch Rosenthal Memorial Webinar: Sexual Functioning after TBI
Angelle Sander, PhD, will discuss current research on sexuality following TBI.
Registration ends July 16, 2013, at 5 p.m. ET. Click here.
July 24, 2013, at 3 p.m. ET:
Discussion of the current status of implementation of the Patient Protection and Affordable Care Act and other legislative and regulatory actions affecting access to rehabilitative care for people with TBI.
Register for this webinar here:
July 31, 2013, 3 p.m. ET, Caregiver Education Series: Getting Things Done with Smart Apps
Michelle Ranae Wild will explore a number of productivity apps available to help after brain injury.
Registration ends July 29, 2013, at 5 p.m. ET. Click here.
I had the pleasure of viewing in preview, a new HBO documentary, The Crash Reel exploring the life and brain injury sustained by American snowboarding champion, Kevin Pearce which will debut on Monday, July
15th at 9 PM eastern time, 8 c on HBO.
As an advocate for persons with a brain injury, I appreciated the compassionate approach to the subject matter. The treatment of Kevin as a person with a brain injury, rather than a brain injured person is a very important message for members of the public. Kevin does not allow his brain injury to define who he is. He is an inspiration to anyone who has sustained a traumatic brain injury.
The stages of the film depicting Kevin’s journey are quite helpful to an understanding of the transitions that an individual and their family members go through following profound brain trauma.
This film will make a very important contribution to the understanding of traumatic brain injury in the minds of the public.
The filmmakers have launched a comprehensive traumatic brain injury awareness and outreach campaign called #LoveYourBrain and the Pearce family has started the Kevin Pearce Fund to support families and individuals
affected by traumatic brain injury and other challenges.
For more information on the documentary, visit their face book site.
Stroke is the fourth-leading cause of death in the United States and the number one cause of disability. According to the Centers for Disease Control, each year an estimated 795,000 people in this country experience a stroke. the No. 1 cause of adult disability?
Did you know that approximately 20 percent of strokes occur in people younger than age 55, and over the past decade?
But, prompt action can greatly reduce the risk of severe disability and death following a stroke. It is important to recognize the signs of a stroke and get the victim to a hospital so that prompt treatment can be instituted. There is now an accepted FDA approved medication known as TPA, a clot busting drug which if administered within the first several hours following a stroke can lead to full recovery.
If you see any one of these "Five Sudden, Severe Symptoms," call 911 -- regardless of the victim's age.
• Sudden numbness or weakness of the face, arm or leg on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing on one side.
• Sudden, severe difficulty walking, dizziness, loss of balance or coordination.
• Sudden, severe headache with no known cause.
It is important to emphasize the words "sudden" and "severe" and the number "one." Any of these symptoms can occur in a mild, fleeting way and not be worrisome, but if any one of them comes on suddenly and is quite severe, it could signal the onset of a stroke, which increasingly is described as a "brain attack," because like a heart attack, a stroke requires immediate action to improve the odds against disability and death.
The medical profession has a saying, Time is brain. The crucial element is time. Rapid transport to a hospital and followed by rapid administration of the clot busting drug greatly improves the chances for a better outcome.
The Court ordered mediation of the lawsuit brought by players against the NFL alleging the league’s fraudulent concealment of the risks associated with concussions was discussed in today’s USA Today, on line edition, Judge orders mediation on NFL concussion suits
I am honored to have been quoted in this article concerning my views on the dangers that a mediated settlement will have in perpetuating the long standing conspiracy by the National Football League and its partners to
hide the dangers and long term consequences of concussions.
Here is a portion of what I said,
Michael Kaplen, questioned whether a settlement – and the confidentially that could entail -- would be in the public interest.
"I'm not so sure it is the right solution to this issue …. The facts surrounding this case are so important not only to the players involved in the case but to everybody else who has an interest in the issue of sports concussions," Kaplen said.
"These facts need to be set forth in the public arena. They can't be hid under the rug in exchange for payment of money. And that's what I'm afraid is going to happen."
Kaplen added, "This impacts any child that's playing any type of sport … the parents, the coaches, the school systems who have looked to the NFL as their model. It goes to college athletic programs, and the implications are just huge. It's like if the tobacco companies settled cases before all the (court) discovery took place, we wouldn't know what they knew, when they knew it and how they hid information."
The American Academy of Neurology (AAN), has launched a new app called "Concussion QuickCheck", to help coaches, athletic trainers, parents and athletes quickly evaluate if someone may have a concussion and needs to seek medical assistance.
The app, which is available for iPad, IOS (Apple), Android, and mobile, was developed in partnership with the Academy’s updated guideline for diagnosing and evaluating sports concussion.
Key information and tools in the "Concussion Quick Check" app include:
Common signs of concussion
Symptoms of concussion
Things the athlete may tell you
What to do if an athlete has a head injury during a game
What to do if it appears the athlete has a concussion
When an athlete should return to the game
Help finding a neurologist near you (GPS capability)
Help finding state laws on concussion
Learn more by clicking here.
Traumatic brain injury in the elderly is explored in a special edition of NeuroRehabilitation: An Interdisciplinary Journal. The guest editor of this collection of articles is the well-known expert in the field of neuropsychology and traumatic brain injury, Wayne A. Gordon, PhD., Vice Chair of the Department of Rehabilitation Medicine at Mount Sinai School of Medicine in New York.
The articles in this special edition address the following subject matters:
A comparison of cognitive function of individuals diagnosed with dementia and a history of TBI with those with dementia and no history of TBI;
Factors related to death following TBI in the elderly based upon medical chart review of individuals 55 years and older who died one to four years after moderate or severe TBI, and compared these to matched living patients;
Characteristics of the inpatient rehabilitation treatments received by individuals with a TBI who were above the age of 65 when they received their injury;
Use of The Brief Test of Adult Cognition by Telephone (BTACT) to screen elderly patients for TBI;
Review of the literature on age-specific factors that are related to successful outcomes in the elderly who sustain a TBI.
We will never solve the concussion problem in sports until players understand that a brain injury can last a life time. But, what we do know is that we cannot rely upon the player to be truthful and accurately report their symptoms. Therefore, we must have longer minimum times that a player is not permitted to return to play following a suspected concussion.
At the annual meeting of the Pediatric Academic Society held in Washington, D.C., a survey was revealed which found that even though young athletes said that they understood the dangers of a head injury, 53% said they would “always or sometimes continue to play with a headache sustained from an injury.” Just 54% said they would “always or sometimes report symptoms of a concussion to their coach.”
Among the surveyed players, 30 reported suffering a concussion and 82 reported having concussion symptoms and risks explained to them. The majority of the high school athletes indicated that they understood that headaches, dizziness, difficulty with memory, difficulty concentrating and light and sound sensitivity were all risk factors for a concussion after a high-impact hit.
The National Basketball Association has released its new concussion policy statement and it leaves a lot to be desired.
Although the policy provides for a series of steps to determine when a player can return to play following a concussion, there is no required minimum amount of time to keep a player out of play, other than preventing him from returning to play on the same day that the injury takes place.
The statement also requires baseline neuropsychological testing of all players before the start of the season and requires a return to baseline before they are permitted to return to play, but as we know, return to base line in and of itself cannot be used as the sole criteria for clearing an athlete following a concussion. Concussions are more complicated than just completing a series of computer questions. Things can and do get worse for those injured by a concussion in the days and weeks following the initial injury even though the player, may return to baseline.
From reading the NBA policy, they seem only to be concerned with brain injury symptoms caused by exertion. What about mood changes, personality changes, behavior changes, memory functions, concentration difficulties, sleep problems, loss of sleep, sensitivity to bright light and sound and the list goes on and on? Shouldn’t they also be considered before a player is permitted to return to play?
Here is the reported National Basketball Association Concussion Policy:
The National Basketball Association Concussion Policy is designed to maximize the neurological health of NBA players by providing a framework of education and clinical management. The policy was created under the core principle that each concussion, and each athlete, is unique. Optimum medical care depends on an individualized and comprehensive approach to concussion management.
1. Education: Every player and coach receives concussion education prior to the beginning of each season. Topics include information on the underlying mechanism of concussion, common and uncommon presentations of concussion, appropriate management strategies and possible complications or long-term manifestations of the injury.
2. Baseline Testing: Prior to each season, each player will undergo testing of baseline brain function, via a neurological and cognitive assessment.
3. Evaluation and Management:
a. If a player is suspected of having a concussion, or exhibits the signs or symptoms of concussion, they will be removed from participation and undergo evaluation by the medical staff in a quiet, distraction-free environment conducive to conducting a neurological evaluation.
b. If a player is diagnosed with concussion, he will not return to participation on that same day.
c. A player that is diagnosed with concussion should have their physical and cognitive exertion limited as much as possible while they are still experiencing symptoms of concussion.
4. Return to Participation Decisions:
a. Once a player is diagnosed with a concussion he is then held out of all activity until he is symptom-free at rest and until he has no appreciable difference from his baseline neurological exam and his baseline score on the computerized cognitive assessment test.
b. The concussed player may not return to participation until he is asymptomatic at rest and has successfully completed the NBA concussion return-to-participation exertion protocol.
5. Return to Participation Protocol:
a. The return to participation protocol involves several steps of increasing exertion — from a stationary bike, to jogging, to agility work, to non-contact team drills.
b. With each step, a player must be symptom free to move to the next step. If a player is not symptom free after a step, he stops until he is symptom free and begins again at the previous step of the protocol (i.e., the last step he passed without any symptoms).
c. While the final return-to participation decision is to be made by the player’s team physician, the team physician must discuss the return-to-participation process and decision with Dr. Jeffrey Kutcher, the Director of the NBA’s Concussion Program, prior to the player being cleared for full participation in NBA Basketball.
d. It’s important to note that there is no timeframe to complete the protocol. Each injury and player is different and recovery time can vary in each case.
In a study from Tel Aviv University published in the Journal, Behavioural Brain Research and Experimental Brain Research, it is reported that the active ingredient in marijuana, known as THC can provide a protective effect from long term damage as a result of traumatic brain injury.
An extremely small dose, around 1,000 to 10,000 times less than that in a conventional marijuana cigarette — administered over a wide window of 1 to 7 days before or 1 to 3 days after injury can jumpstart biochemical processes which protect brain cells and preserve cognitive function over time
The study authors claim that these low doses will protect the brain from long-term cognitive damage in the wake of injury from hypoxia (lack of oxygen), seizures, or toxic drugs. The use of THC can prevent long-term cognitive damage that results from brain injury, the researchers conclude.