Brain Injury Lawyer - New York

Support For Students Suffering from Traumatic Brain Injury

The Brain Injury Association of New York State (BIANYS) has created a program known as PROJECT LEARN (Living Education And Resource Network) which provides a great resource to students, teachers and family members to assist them in addressing the issues faced following a traumatic brain injury.

Among the goals of Project LEARN ARE TO:

• Create and sustain competency for families and school staff in addressing challenges of children with brain injuries.
• Establish an interactive, user-friendly web based information and resource program (LEARNet).
• Provide access to the expertise of the Brain Injury Association FACTS coordinators as well as an extended support network of professionals, families educators as well as other resources.

Visit the Project LEARN web site for further information.

The New York Brain Injury Association is also sponsoring a one day training symposium "Building Capacity: Supporting Children With Brain Injury and Their Families which is scheduled to be held on Friday, April 25, 2008 from 8:00 AM - 4:00 PM at the NYS United Teachers offices at 800 Troy-Schenectady Road, Latham, New York.  More information on this program which will explore the a variety of issues pertaining to traumatic brain damage in children and the challenges of returning to school can be found on the brain injury association web site.

Brain Fitness Software

Over at SharpBrains, they report about the State of the Brain Fitness Software Market.

I never paid much attention to brain fitness software but the conclusions of this report are quite fascinating.  The size of this market surely will cause more companies to become involved.  While there is a potential that some of these products may indeed improve cognitive fitness and have a place in brain injury rehabilitation, I am fearful that many of these products will never live up to their potential and will just be a ripoff for those who can least afford it.

Highlights from The State of the Brain Fitness Software Market 2008 report include:

1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues – up from an estimated $100 million in 2005.

2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.

3) The Nintendo Brain Age phenomenon has driven much of the growth. The consumer segment grew from a few million in 2005 to an estimated $80 million in 2007.

4) There is major confusion in the market, so education will be key. Users and buyers need help to navigate the maze of products and claims.

5) Over 400 residential facilities for older adults have launched computerized “brain fitness centers.” Sales to the healthcare and insurance provider segment grew from $35 million in 2005 to an estimated $65 million in 2007.

6) More than five programs have shown results in randomized controlled trials. Cognitive functions that can be trained include: visual and auditory processing, working memory, attention, and decision-making.

7) A product has obtained 510(k) FDA clearance for rehabilitation of stroke and Traumatic Brain Injury patients. Another product is being used by a growing network of ADHD specialists.

8) Large-scale, fully-automated cognitive assessments are being used in a growing number of clinical trials. This opens the way for the development of inexpensive consumer-facing, baseline cognitive assessments.

9) The potential for K12 Education remains largely untapped due to limited research linking cognitive training to academic performance.

10) Companies, sports teams and the military are finding opportunities to improve productivity. The aging workforce will make this a must.

Depression Following Traumatic Brain Injury

If you live in the New York City metropolitan area, have had a traumatic brain injury and are experiencing depression, or if you know people who fit that description:

The Research and Training Center for Traumatic Brain Injury (TBI) Interventions at Mount Sinai School of Medicine is seeking people who have had a TBI and are experiencing depression. The research study will evaluate the effectiveness of two different psychotherapy treatments in helping individuals who are depressed after brain injury. To participate in this study, you must be suffering from depression and be willing to participate in one of the psychotherapies for 4 months. If interested, please call Mt Sinai’s Rehabilitation Research and Training Center at 212-241-5152. If you live outside of the five New York City boroughs, you may call toll free at 888-241-5152. 

What set's us apart from most personal injury law firms is our commitment and passion to protect the rights of brain injury victims.-- De Caro & Kaplen, LLP Provides Compassionate Legal Representation to the Victims of Negligence and Their Families.  Visit us at brainlaw.  Review our legal guide to traumatic brain injury.

Potential Help for Tinnitus Following Traumatic Brain Injury

One of the most frequent complaints following both mild and severe traumatic brain injuries is tinnitus, a perception of sound such as ringing in the ears or other sensations such as high pitch beeps or buzzing when non exists.

Unfortunately, to date there has been no cure for this very troubling condition.

Today's Wall Street Journal contains an interesting article on a new product that trains the brain to filter out this annoying sound.  The article also has some important information about tinnitus.  While a make no recommendation about the device the article discusses, I do recommend that you read the story, Training Your Brain To Ignore Tinnitus.

University of Central Florida Announces New College Academic Brain Injury Rehabilitation Program

Then University of Central Florida (UCF) has announced that it is is launching a TBI Program to provide academic rehabilitation to college students suffering from a traumatic brain injury. According to UCF it is the first university in the country to offer such a program on campus, and its leaders believe it will become a national model.

The program also will give graduate students studying communication disorders the opportunity to learn key techniques and therapies to help people master the long-term mental challenges related to TBI. They will be able to take courses on TBI beginning in the summer and will learn by working side-by-side with their supervisors.

Depending on the severity of the injury students may experience difficulties remembering information, taking accurate and complete notes, demonstrating knowledge on exams and organizing their study time. The treatment teaches students strategies that allow them to think effectively using the brain systems that are still healthy.

The cost of treatment, which isn’t typically covered by insurance, runs about $70,000 for about 400 clinical hours. But in Florida, those who have been diagnosed with TBI can get treatment paid for by a special state fund for rehabilitation of brain and spinal cord injuries according to the University.

You can read the full news release regarding this program by clicking here.

New York State Traumatic Brain Injury Services Coordinating Council: Next Meeting

The next meeting of the New York State Traumatic Brain Injury Services Coordinating Council which I am honored to chair will take place in New York City on March 28, 2008 from 10:30 AM - 3:00 P.M. at the offices of the  New York State Department of Health, 90 Church Street, New York, NY  4th Floor Conference Room.

The Council is charged with recommending to the Department of Health, long range objectives, goals and priorities as well as providing advice on planning, coordination and development of needed services.

Since becoming Chair of the Council, it has been my goal to increase public participation in the work of the Council and provide meaningful recommendations and assistance to the Health Department.  At our last meeting, I formed new committees to look at various aspects of traumatic brain injury in New York State and formulate specific proposals that can be forwarded to the Commissioner of Health.  Since that meeting each of the committees has met and formulated an agenda which will be presented at this upcoming meeting.

The council will also hear reports from various state agencies on their TBI programs.

Additionally, at this meeting we will hear a presentation on Traumatic Brain Injury and Substance Abuse Issues and will discuss recommendations that can be made to improve services in this area.

It is important to note that due to security, anyone who wishes to attend MUST contact Dawn Crary to register.  If you are not registered in advance, then you will not be allowed access to the building.

Here is the tentative agenda for our March 28th meeting:

10:30am – 10:35am Welcome and Review and Approval of Minutes from the December 12, 2007 Council Meeting

10:35am – 11:00am TBI Waiver Program Update
                             Pat Greene-Gumson, NYS Department of Health, Office of Long Term Care

11:00am – 11:45am Presentation: Traumatic Brain Injury and Substance Abuse Issues
                              Ed Ross, International Center for the Disabled
                              Tamara Miller-Kammerer, OASAS, Blaisdell Addiction Treatment Center 
   
11:45am – 12:45pm Group Discussion re: Presentation

12:45pm – 1:15pm Lunch

1:15pm – 1:45pm State Agency Reports

1:45pm – 2:15pm Subcommittee Reports

2:15pm – 2:45pm Public Comment Session
   
2:45pm – 3:00pm Summary/Next Steps/Adjournment

Coma: The Toll on Families

This Sunday's New York Times has an article,  Holding on to Hope which captures the toll that severe brain injury including coma and the persistent vegetative state has on parents and other loved ones.

The article describes the difficulties faced by three families of army veterans attempting to get the best care for the severe brain damage sustained by their son's who were injured in the Iraq and Afghanistan conflict. 

The battles with the VA to obtain placement in a private brain injury rehabilitation facility with a national reputation as well as the day to day struggles that these families face are highlighted in the story.

I have spoken many times on the need to address the second patient in brain damage, that being the family.  Mothers, fathers, spouses and children are in many ways equally in need of assistance following a brain injury.  Yet, their needs are often not addressed by the medical community.  It is important to remember that these family members often need counseling and other assistance to enable them to continue with the journey following a traumatic brain injury.

Concussions complicated by post traumatic stress disorder and depression

A new study published this week in the New England Journal of Medicine links the persistent problems following a concussion to the development of post traumatic stress disorder and depression.

According to a summary of the study reported in today's New York Times, the new report finds that soldiers who had concussions were more likely than those with other injuries to report a variety of symptoms in their first months back home, including headaches, poor sleep and balance problems. But they were also at higher risk for the stress disorder, known as PTSD, and that accounted for most of the difference in complaints. Symptoms of the disorder include irritability, sleep problems and flashbacks.

You can read the full Times story by clicking here.

Full Military Traumatic Brain Injury Task Force Report

My earlier post today concerned the Military Traumatic Brain Injury Task Force Report.

The full report can be read by clicking here.

Army Study Reports One In Five Brain Injuries Go Unrecognized

In a study released yesterday, the Army has confirmed that Up to 20 percent of U.S. troops returning from Iraq and Afghanistan may have suffered mild concussions but were unaware of them and did not get treatment.

The study reports that the Army has a hard time identifying and treating affected troops because the soldiers and Marines don't recognize the symptoms and don't report them.

"The Army is challenged to understand, diagnose and treat military personnel who suffer with mild TBI," said Brig. Gen. Donald Bradshaw, who leads the Army's TBI task force.

In addition to recognizing the common symptoms of a concussion such as headaches, dizziness, sleep disorders, nausea or memory problems, the Army is now alerting soldiers and their families to the psychological consequences of closed head injury such as irritability, anxiety and depression.

The earlier that these soldiers recognize and report their symptoms, the earlier that they can get treatment.  Just as important, soldiers who are still on active duty need to know that these symptoms are important to report so that they are not exposed to a second head injury before they fully recover from the initial injury they received.

 

Brain Injury Webcast: "Veterans with TBI"

A web cast which will  provide an overview of the Veterans Health System and address the structure and services available for veterans with TBI and their families by the  Program Manage of the Department Veterans Affairs will take place on Friday, February 1, 2008, from 2:00 pm to 3:30 pm  "Veterans with TBI - The Veterans Health System." 

According to the Department of Veteran Affairs, this Web cast will be useful as a first step in understanding the VA system.  As service members with TBI are identified in State and community systems, it will provide an idea on where to refer them so that appropriate benefits are received.  Ideas for outreach and potential partnerships might also be a potential outcome.

The web-cast REQUIRES PRIOR on-line registration to ensure that your computer meets all technical requirements.  To register click here   You should register well in advance of February 1st to resolve any potential technical issues before the web-cast.  Should you experience any technical difficulties while registering, please submit a question to them by clicking here .   On February 1st, be sure to use the same computer to view the Web cast that you used to register. Connect 20 minutes in advance of the web-cast to ensure your connection and to download the Power Point slides.

For anyone who can't be present for the February 1st web-cast, there will be an archived copy available about one week after the event by clicking here .

Rehabilitation Following Severe Traumatic Brain Injury

The hardships, frustrations and rewards associated with rehabilitation following a severe traumatic brain injury are discussed in an article in today's New York Times, Coaching the Comeback.

The article describes rehabilitation efforts at Keller Institute of Rehabilitation in New Jersey and the difficulties and rewards of this work intensive and heart breaking endeavor.  The dedication of professionals involved in the rehabilitation of survivor's of a traumatic brain injury should never be forgotten. They deserve our thanks.  They also deserve salaries that reflect their skills and efforts.

Insurance carriers need to be compelled to provide reimbursement for these essential services without arbitrary limits on the number of days that a person is entitled to services, the types of services that an individual can receive or ignorant assertions that they have reached maximum levels of improvement.

Long Island Brain Injury Symposium

The Brain Injury Association of New York State is holding a symposium for brain injury professionals, survivors, families, caregivers and community advocates hosted by Transitions of Long Island.

The symposium is scheduled for Saturday March 8, 2008 from 9:00 AM to 3:00 PM at Rust Auditorium, North Shore University Hospital in Manhasset.  Lunch and refreshments will be provided.

Scheduled topics include: New Technologies, Maintaining Health and Wellness, Work Integration, Special Issues faced by Men and Women, the TBI Medicaid Waiver Program, Guardianship and Trust Issues.

For further information e mail Dr. Deborah Benson

Free Online Test to Help Assess Vision Loss After Stroke or Traumatic Brain Injury

NovaVision, Inc. today launched a free online vision test for stroke and brain injury survivors who wish to learn if a vision deficit exists as a result of their injuries. The interactive test, is available  by clicking here and according to the company,  provides immediate results to people who want to learn more about their visual acuity.

Impaired vision often occurs as a result of brain damage.  This impaired vision can affect not only sight but balance as well.  It greatly impacts every aspect of a person's life from reading to driving and in performing routine tasks such as walking.

There are specialized programs throughout the country that provide visual rehabilitation following a traumatic brain injury.   In New York, one of the leading programs is at the SUNY College of Optometry which has a specialized brain injury visual rehabilitation program.

Top ten emerging areas of neuroscience research

The Neurotechnology Industry Organization (NIO) has announced the top ten emerging areas of neuroscience that will impact the future of treatments for brain and nervous system.

According to NIO, the trade association that represents the 500 companies worldwide developing treatments for the brain and nervous system, the US economic burden of brain-related disorders has reached more than $1 trillion, highlighting the acute need for continued neuroscience research and therapeutic development.

Top 10 trends of 2007:

• Advancing discovery tools underpin innovation: beyond biochips and brain imaging, recent advances in neuroinformatics, image-based neural circuit analysis, and neural computation are accelerating the pace of neuroscientific discovery beyond what was imagined a decade ago.
• Neuroimmunology leading to new treatment targets: the discovery that immune molecules play a crucial role in shaping neuronal connections opens up new treatment targets for Alzheimer's, autism, ALS, Parkinson's, schizophrenia, and nerve injury.
• National Neurotechnology Initiative: momentum for the new $200M/year federal R&D initiative aimed at accelerating translational neurotech innovation and improving the effectiveness of FDA review process for neuroscience drugs, devices and diagnostics grows.
• Neurodevice interfaces improve prosthetics and treatments: advanced brain-machine interfaces (BMI) enable the severely handicapped to independently compose e-mails and operate a TV in their homes. Other neurodevices provide functional stimulation for the treatment of pain, Parkinson's, obesity, and psychiatric disorders.
• Addiction advances: new research clarifies the role of drugs on sleep, cocaine's potency, and the brain changes that occur due to abuse leading to new treatment strategies for this epidemic impacting over 1.1 billion worldwide.
• Normal aging brain gets more attention: more research and development is being focused on thinking impairments that only partially limit independence and quality of life for senior citizens, adults and school aged children.
• Neurosoftware will penetrate nursing homes and schools, as brain fitness software becomes new first-line treatment strategy.
• Regenerating the spinal cord: new experimental therapies in development could open the doors for research to improve treatments for people with spinal cord injuries, brain injuries, stroke, and other severe movement disorders
• Prevention evidence grows: you are what you eat; smoking is as bad as we thought; and new studies reveal the effects of environmental substances on Alzheimer's disease, Parkinson's disease and others.
• Emotional disorders research advances: new research continues to link neurogenesis to treatment of depression. A better understanding of PTSD should lead to new treatment regimes.
• Neuroscience infiltrates society: from neuroeconomics to neuroesthetics to neuroethics and neurolaw, the influence of neuroscience on society continues to grow.

New Lead Poisoning Recommendations Released by CDC

The Center for Disease Control's Advisory Committee on Childhood Lead Poisoning Prevention has issued new recommendations in a report issued last week.

Lead contamination and exposure to lead is associated with significant cognitive impairments, motor impairments and behavioral difficulties in children.  In 1991 the CDC defined  the blood lead level (BLL) that should prompt public health action as 10 units.  Since that time, strong evidence has been discovered to show that lead levels below 10 units should be of concern to public health officials as well as parents and medical personnel. 

The full CDC Lead report  can be found on line at the CDC web site. The report is dated November 2, 2007 and is number 56(RR08); 1-14; 16

Children with Brain Injuries Can Benefit From New York State Brain Injury Association Web-Based Information and Resource Program

The Brain Injury Association of New York State BIANYS has launched LEARNet, a Web-based information and resource program, funded by the state Developmental Disabilities Planning Council.

Each year, more than 30,000 children become permanently disabled following a brain injury. Many more, often unaccounted for, appear to have recovered from their injuries only to have problems resurface later as they encounter increased social, academic and developmental challenges.

Problems can include behavior outbursts, cognitive changes and depression resulting in academic problems and alienation from peer groups.

LEARNet offers, along with resource information, a comprehensive problem-solving tool designed to help teachers and families find solutions to these often challenging and frustrating problems.

In addition to LEARNet, the association's Family Advocacy, Counseling and Training Services Program provides links for individuals injured before age 22 and their families with community-based services and supports.

FACTS coordinators throughout the state are on hand to educate the public about brain injury, available services and prevention.

For more information about LEARNet, the FACTS Program or any of the association's other programs, you can visit the association web site: Brain Injury Association of New York State , by phone at (800) 228-8201, by e-mail.

Public Input Requested for the Brain Injury Summit

A Brain Injury Summit is scheduled for November 2-3, 2007 in Washington, DC jointly sponsored by the Brain Injury Association of America (BIAA) and the North American Brain Injury Society (NABIS).  You are invited to provide input into one or more of the focus areas listed below.  Your comments will be furnished to work group moderators who will write the final document. 

Acute Care
Sub-acute and Post-acute Care
Long-term, Community Integration & Case Management
Mild TBI & PTSD
Systems Issues
To provide input to the established work group questions, please click on this link.

The Summit will result in a white paper/position statement on improving the quality of care and long-term living for individuals with brain injury, including civilians, service members and veterans. Advocates at the federal and state levels and in the private sector will utilize the position paper for advocacy efforts. 

I encourage all those involved in the brain injury movement including persons with a brain injury, family members and professionals to participate in this important advocacy effort.

10-in-10 Project

I had the privilege this morning of having breakfast with Peter C. Kinney, the treasurer of a really good not for profit organization known as the 10 in 10 Project whose goal is to assist our brain injured troops and the civilian population who are living with brain injuries and are unable to afford or access the necessary assistance.

Through a fund raising program called Tickets of Hope they are raising funds to assist those in need and provide a kit known as the Brain Injury Recovery Kit produced by Day Timer which is a memory aid and planner for brain injured individuals.

Donations totaling $600 purchase one Ticket of Hope™

For each Ticket they sell the the 10 in 10 Project is able to provide:

• One Brain Injury Recovery Kit™ shipped to the individual's home,
• A support program for use of the Kit with the assistance of The Brain Injury Association of New Mexico, (BIANM)
• Membership to the Chartered Affiliate Brain Injury Association in the individual's state to be guided to additional resources.

I look forward to working with this dedicated group of individuals on this project.

You can get further information by visiting the 10 in 10 Project web site. You can also e mail them for further information and to request assistance.

Mid Hudson, New York Brain Injury Conference

I look forward to participating this Thursday, September 20th in the 2007 Mid Hudson Brain Injury Rehabilitation Conference sponsored by the Northeast Center for Special Care.

I have been asked to provide the lead off presentation on the important topic of Ethical Considerations in Dealing with the Brain Injured Population.  It is a presentation that I enjoy giving to clinicians, lawyers and other professionals on the need to treat persons with a brain injury with RESPECT and an understanding of their cognitive strengths and weaknesses.  Some of the points that I will be making include the need to schedule appointments with extra time, the need to provide written information for individuals to take home so that they can go back and refer to the conversations that you had, the need to understand some of the unique challenges that face persons with a brain injury such as sensitivity to bright lights and distracting back ground sounds and the accommodations that need to be made, the need to understand that at times, behavior may not be what one is used to, the need to repeat and reinforce information presented and perhaps schedule follow up appointments. 

Other speakers throughout the day will focus their discussions on issues such as post traumatic stress disorder and brain injury, issues of addiction following a brain injury, biofeedback programs and visual disturbance following a traumatic brain injury.  You can get further information about the conference by downloading the conference brochure by clicking here.

The conference is scheduled to begin at 8:00 AM and run to 5:00 PM at the Holiday Inn in Kingston. You can register by telephone by contacting Deborah Muise at 845 336 3500 xt 3262

Virginia Faulted on Care to Brain Injured

A report issued by a Virginia legislative review commission concluded that tens of thousands of people in Virginia with traumatic-brain injuries lack adequate residential facilities, access to therapy, transportation or occupational help. 

Further jeopardizing the already taxed system of brain injury care in Virginia is the prospect of returning veterans with brain damage who will also require care with no plans on how to deal with this growing epidemic. 

Unfortunately, Virginia is not the only State that lacks the proper resources to adequately care for the thousands of individuals who must live with a traumatic brain injury on a daily basis. Most states do not maintain proper statistics on the number of individuals who sustain brain injury in a give year and lack proper support services for brain damaged individuals and their families.  Rehabilitative services in many places are fragmented and not easily accessible.  Most states have improper levels of funding to support brain injury services and most individuals do not receive the services they deserve.

In Virginia, most if not all facilities will not accept Medicaid to pay for residential care.  In fact, the only facility in the state that does accept Medicaid payments for residential care for traumatic brain injury victims will stop accepting these patients later this month.

But, Medicaid funding is not the only issue.  Issues of private insurance and why these health insurers are not paying for brain injury rehabilitation services needs to be addressed.

You can read more about this 130 page report by clicking here.

Taking on the VA For Brain Injury Rehabilitation

The Boston Globe in an important article reports on the success and failures of returning veterans and their families in obtaining brain injury rehabilitation services outside of the Veterans Administration network.

I have been saying for a long time that I can't understand why the VA will not allow brain damaged vets to obtain services in facilities that are not only close to their home but provide expertise that the VA still is incapable of providing.  It simply makes no sense that the VA is trying to reinvent the wheel.  Why not use the available services that are available in the community to provide care to returning vets.  The adamant attitude of do it our way or not at all simply needs to change!

Read the full story Families wage fight for brain injured.  Thanks to the Going Through the Motions blog for alerting me to this story.

The Plight of the Brain Injured in Ireland

According to an article in the Irish Times, the rehabilitation of those with brain damage in Ireland is woefully inadequate.  Although some 10,000 people suffer head or brain trauma every year in Ireland, traumatic brain injury is still not recognized as a distinct or unique disability by the health authorities and there is no national strategy for support services according to the Peter Bradley Foundation a victim's rights group. 

Interestingly, the Irish public health authorities do not yet recognize traumatic brain injury and the disability that it causes as a separate disease entity and fail to provide direct funding for TBI support services.

The foundation charges that the the waiting time to obtain needed services  can be three to six months depending on the complexity of the brain injury and, for minimally conscious brain injury patients, waiting times average 18 months!

New Job Resource For Brain Injury Professionals

The North American Brain Injury Association (NABIS) has launched a new employment resource for brain injury professionals, allowing them to post and review resumes and job information on line.

For Employers: Target a focused audience of qualified brain injury professionals, post your jobs, search resumes and promote your company on-line.

For Job Seekers: Post your resume - confidentially if you choose. Search job listings and receive automatic email notification whenever a job matches your specific criteria.

You can visit the NABIS brain injury professional career resource center by clicking here.

VA Offers On Line Traumatic Brain Injury Course

The United States Department of Veterans Affairs (VA) offers an on-line Traumatic Brain Injury (TBI) Independent Study Course.  This curriculum presents an overview of TBI issues that primary care practitioners may encounter when providing care to veterans and active duty military personnel.  While it is primarily designed for medical personnel and other practitioners interested in traumatic brain injury care, the course contains useful information for everyone.

You may access the on-line independent study course directly by establishing a username and password by clicking here.  When you go to the site you can also download a pdf version of the course without registering. 

Traumatic Epilepsy Centers Proposed For Returning Vets

U.S. Senators Patty Murray (D-Wash.) and Larry Craig (R-ID) introduced joint legislation to establish six Department of Veterans Affairs (VA) Epilepsy Centers of Excellence across the country.  The bill is designed to with the treatment of post traumatic epilepsy following brain trauma. 

The Murray-Craig bill authorizes $6 million annually for the Epilepsy Centers of Excellence to support clinical, research and education efforts surrounding the incidence of epilepsy among current and future veterans with head and brain injuries.

According to Senator Craig, "Experts have indicated that half of all Vietnam veterans who suffered penetrating brain injuries suffer from what is known as 'post-traumatic epilepsy' many years down the line.  While there is no evidence yet as to the impact of TBI-induced epilepsy from the wars in Afghanistan and Iraq, this bill will ensure that we are prepared for that possibility,"

At a May hearing, Dr. John Booss, MD,, testified before the Senate Veterans Affairs Committee about TBI on behalf of the American Academy of Neurology. 

Booss told the committee that VA-funded research, conducted in collaboration with the Department of Defense, found that 53 percent of veterans who suffered a penetrating TBI in Vietnam developed epilepsy within 15 years.  For these service-connected veterans, the relative risk for developing epilepsy more than 10 to 15 years after their injury was 25 times higher than non-veterans in the same age group.

"Indeed, 15 percent did not manifest epilepsy until five or more years after their combat injury.  As neurologists, we believe that the rate of epilepsy from blast TBI will also be high," Booss said.

The Murray-Craig bill would require the designation of the Epilepsy Centers of Excellence within 120 days after enactment. The locations of the centers would be determined by the VA Secretary, upon recommendation of the Under Secretary for Health based upon a competitive process to assess the scientific and clinical merit of the proposals from VA medical facilities.  The review panel is to be assembled by the VA Director of Neurology and consist of experts in epilepsy, including post-traumatic epilepsy.  The VA Director of Neurology will be responsible for supervising the operation of the Centers and shall provide ongoing evaluation of the Centers.

While I laud the purpose behind this legislative proposal, I would also recommend that those suffering from traumatic epilepsy be permitted to seek treatment in established epilepsy centers that already exist in medical centers throughout the country.  To require veterans to receive this type of care only at established VA centers fails to take into account the expertise that already exists in this area and the proximity that non VA centers may have to where veterans actually reside.

fMRI Used To Detect Concussions and Return to Play Decisions In Athletes

fMRI (Functional MRI studies) have been reported to be used by the University of Pittsburgh to assist in making important return to play decisions following sports concussions.

A five year study funded by the National Institutes of Health is published in the August issue of Neurosurgery.  This study conducted by the Sports Medicine Concussion Program at the University of Pittsburgh School of Medicine  found that the brain activity in children and adolescents on functional MRI (fMRI) was clearly related to their performance on neuropsychological tests of attention and memory and to their report of symptoms such as headaches.

The study authors Drs Lovell and Collins conclude that the results of their study confirm crucial objective information that is commonly obtained by neuropsychological testing to help team doctors and athletic trainers make critical decisions about concussion management and safe return to playor understanding the recovery process after sports-related concussions.

The study helps define concussion and recovery for safe return-to-play and confirms information obtained by neuropsychological testing.

A concussion can occur when an athlete receives a traumatic force to the head or upper body that causes the brain to shake inside of the skull. Injury is defined as a concussion when it causes a change in mental status such as loss of consciousness, amnesia, disorientation, confusion or mental fogginess. The severity, effects and recovery of concussion are difficult to determine because no two concussions are alike, and symptoms are not always straightforward.

In recent years, research has shown that until a concussed brain is completely healed, the brain may be vulnerable to further injury, which has led to published studies that have raised public awareness and significantly changed the way sports concussions are managed. Importantly, much of this research has included data that proves the usefulness of objective neuropsychological test data as part of the comprehensive clinical evaluation to determine clinical recovery following concussion.

While neuropsychological testing has become an increasingly useful tool, no other published studies have examined the relationship between changes in computerized neuropsychological testing completed in a medical clinic and brain function as measured by fMRI.

fMRI is one of the few brain scanning tools that can show brain activity, not just the anatomy. Traditional brain scanning techniques such as MRI and CT are helpful in viewing changes to the brain anatomy in more severe cases, but cannot identify subtle brain-related changes that are believed to occur on a metabolic rather than an anatomic level.

fMRI can determine, through measurement of cerebral blood flow and metabolic changes, which parts of the brain are activated in response to different cognitive activities.

For more information on published research concerning sports concussion management, visit the UPMC Sports Medicine Concussion Program Web site .

California Veterans With Brain Damage To Receive Free Assistance From Easter Seals

Easter Seals is launching a pilot project to help veterans of Iraq and Afghanistan with mild to moderate Traumatic Brain Injury in San Diego and Riverside counties in California.

At the onset of the project, three affiliates of Easter Seals with funding from the Ludy Family Foundation, will provide cognitive rehabilitation through the use of a computer based training program that is designed to improve memory, communication and clarity of thinking.

Veterans and their families can obtain further information by calling toll-free, (866) 423-4981, or by sending an e-mail to easter seals. The program is offered at no charge to participants.

Army Institutes Educational Campaign to Recognize Traumatic Brain Injury

The Army in recognition of that many, if not most brain injuries are invisible to the casual and even medical observer, is launching an education program to teach 1 million soldiers how to recognize symptoms of brain injuries and Post Traumatic Stress disorder.

The program is designed to educate the Army about the signs and symptoms of traumatic brain injury and concussions and to encourage troops to get treatment.

The program will include the active military, the Army Reserves and the Army National Guard, both here and abroad.

Everyone is to receive a one-hour briefing on brain injuries and stress, in which teachers will be equipped with videos, slides and a list of expected questions and answers. It will be done through a rarely used "chain teach" program, that is, the subject is taught to leaders, who then teach it to soldiers, continuing down through the Army's chain of command.

I wonder if this program can be modified and used at all emergency rooms in the United States to train doctors, physician assistants, nurses and others about the hidden and invisible signs of concussion and brain injury?

State to screen returning troops for brain injury

The state of Illinois has announced that it would begin mandatory screening of their National Guard members who were deployed to Iraq and Afghanistan for traumatic brain injuries.

Reportedly, Illinois officials have become increasingly frustrated with the screening procedures of the federal government and the services and support available made available to returning vets with brain damage by Washington.

So, state veteran affairs officials have taken matters into their own hands.  They will require mandatory screening for brain injury of all returning members of their national guard and offer brain injury screening to other veterans of the state.  They will also provide a 24-hour hot line for psychological counseling services for brain injury victims.

Medical professionals in Illinois recognize the difficulties in detecting mild traumatic brain injury and are directing special attention to the symptoms of mild brain injury including irritability, headaches, dizziness, memory problems, feeling tired or feeling groggy.  The screening program includes a written questionnaire and an assessment by a trained brain injury professional.  Any soldier with a suspected brain injury would then be referred to a veterans center for further evaluation and treatment.

Hopefully, more states will follow the Illinois example and establish traumatic brain injury screening programs themselves.

You can read the full story in the New York Times, Screening for Brain Injury Is Set for Illinois Veterans, by clicking here.

Understanding Traumatic Brain Injury Video Available

The Defense and Veterans Brain Injury Center's (DVBIC) documentary, "Understanding Traumatic Brain Injury," is now available for viewing on their website.

"Understanding Traumatic Brain Injury" is a 29-minute program, introduced by General Colin L. Powell, USA (Ret.).  It offers an introduction to traumatic brain injury, a health issue affecting at least 1.4 million Americans each year.  It features the recovery journeys of several service personnel and their families.

Click here for a link to view the video.

Viewers can also visit  the DVBIC web site and click on the education tab at the top of their home page. 

Two related products are also available on the same page at their website:

1) a fact sheet on traumatic brain injury (TBI) awareness and prevention, and

2) a "Documentary User's Guide" for organizations that plan to use this documentary as part of their educational efforts in 2007.  See the website for ordering details.

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.

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. 

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.

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 e