Brain Injury Lawyer - New York

New Medical Treatment for Pediatric Brain Trauma

Cooling the body can have positive affects on children who suffered severe traumatic brain injury according to a new study published in the April Issue of the journal, Neurosurgery.  A press release from the authors of the study can be viewed by clicking here.

The study claims that cooling the body (hypothermia) following severe brain trauma may slow down or block the release of chemical substances in the brain that are released when the brain is injured.  The release of these chemical substances (termed a chemical cascade) have been thought to lead to brain damage.  Cooling the brain can also help to control brain swelling and intracranial pressure, which according to the authors, if left unchecked can lead to further brain damage following the initial injury.

In the past, the Brain Trauma Foundation, has issued guidelines for the treatment of severe brain injury. I am wondering what thoughts, Dr. Jamshid Ghajar, M.D., Ph.D., the President of the Brain Trauma Foundation has in regard to this new study?

Device Claims It Can Detect Concussions

An interesting article in today's Newsday concerns a device which it's designers claim can detect concussions in injured  players.   The device known at "DETECT" short for Display Enhanced Testing for Concussions and Mild Traumatic Brain Injury System shows an injured player a series of words and shapes to test his cognitive ability and memory.  It was designed by researchers from Georgia Institute of Technology and Emory University.

While I applaud continued research to determine whether an athlete has sustained a concussion, the severity of the concussion and the all important decision, when to allow the athlete to return to play, I question the utility of this device and the reliance on it to make these important decisions.

A simple test given seven minutes after an athlete sustains a potential concussion, will not provide anybody with enough information to make an intelligent decision and in fact reliance on the results of this test may even cause further injury and devastating life long problems.

A concussion is a subtle injury to the brain manifest by many different and varied symptoms.  Physical symptoms of a concussion may include headache, dizziness,  nausea, vomiting, blurred vision, gait instability.  Cognitive symptoms of a concussion may include attention problems, memory problems, concentration problems and orientation problems.  Behavioral changes may also be symptoms of a concussion including irritability, depression and anxiety. 

It is important to remember a person can have sustained a concussion and not exhibit all of these symptoms.  It is also important to remember that some of these symptoms take hours, days or even weeks to manifest themselves.

Why the rush to return athletes to play within minutes of sustaining a potential brain trauma?  Brain Injury can last a lifetime, prudence is the proper course to follow.

Brain Injury and Community Based Issues

This month's issue of "Brain Injury", a publication of the North American Brain Injury Society, www.nabis.org is devoted to the issues surrounding returning to the community following a brain injury.  The transition back to the community following brain trauma is always difficult and frustrating for individuals and their families.    The articles underscore the difficulties faced in community reentry and the various approaches available to assist in the transition and to assist in the long term care and living problems following traumatic brain injury. 

Here is an index of the articles:

"Acknowledging severe brain injury as a chronic disability.  Developing viable community resources where they are most needed"

"Skill acquisition and automatic process development after brain injury: A holistic habit retraining (HHR) model for community reentry"

"Discharge planning following traumatic brain injury"

"A quality scorecard for community based services"

"Evaluation and treatment plan implementation in community re-entry following brain injury: A neuropsychological approach"

The North American Brain Injury Society (NABIS) is a professional organization made up of brain injury professionals including neuropsychologists, neurologists, lawyers, life care and discharge planners and others interested in brain injury and improving the lives of persons with a brain injury.  All professionals in the brain injury field should consider joining.  To joint NABIS or to learn more about the organization, visit their web site, www.nabis.org

Traumatic Brain Injury in the United States: CDC Slides Available

The Center for Disease Control has just released a set of power point slides which detail information and statistics about traumatic brain injury related deaths, hospitalizations and emergency department visits in the United States for the years 1995-2001. The information in the slides is derived from the November 2004 CDC report entitled "Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Death"  The slides can be viewed and downloaded at http://www.cdc.gov/ncipc/tbi/SL/TBI_in_the_US.htm 

Brain Injured Cyclist Awarded $10.3 million

A jury in Palm Beach County rendered a verdict of $10.3 million in favor of a cyclist for brain injuries sustained when a van struck him and threw him over 100 feet according to the Sun-Sentinel. 

The injured bicycle rider was thrown 100 feet from his bike when a drunk driver struck him resulting in severe head trauma.   He was unconscious for two weeks.

Although he was wearing a bicycle helmet, it came off on impact.  A law suit was also brought against the helmet manufacturer alleging that a helmet should not become dislodged when hit, but the jury rejected that claim finding the drunk driver 100% at fault.  You can read the entire story by clicking here.

New York Legislature Concerned with Concussion Injuries to Student Athletes

The Chairman of the New York State Senate Health Committee, Kemp Hannon has introduced legislation requiring each and every school district in New York State to develop and implement guidelines to determine when a student who has suffered a head injury can return to athletic play, gym class or a school sponsored competition.  The proposed legislation also requires written medical clearance before a school district can allow a student who has sustained a concussion to return to play and further requires that the school district develop a system to track the number and severity of concussions that a student receives throughout his years of school attendance.  The proposed legislation is New York Senate Bill number S02005.  You can read the full text of the bill by going to http://public.leginfo.state.ny.us/menuf.cgi and entering the bill number.  You can send Senator Hannon your comment's on his proposal by e mailing him at [email protected]

Yesterday I had the pleasure of meeting with Senator Hannon and his staff at his offices in Albany to discuss this important legislation.

  Senator Hannon should be commended for recognizing the dangers faced by school athletes who have sustained concussions and the dangers that they face if allowed to return to play prematurely.  Further information on the important issue of concussions in sports and the new guidelines promulgated by the 2nd International Conference on Concussion in Sport can be found by clicking here.  I have also discussed this important topic in my post of 3-29-2005 which you can scroll to below.

Brain Injury Education Program on Neurobehavioral Issues Following TBI

The National Association of State Head Injury Administrators (NASHIA) has announced a series of three webcasts discussing the causes, consequences, assessment, treatment approaches to neurobehavioral issues following traumatic brain injury.  They will also discuss community and state responses to these important issues.

The web cast format is a one hour audio presentation followed by another hour of questions and answers.  The schedule of the web casts is April 14, 2005 at 1 PM eastern time, April 28, 2005 at 1 PM eastern time and May 12, 2005 at 1 PM eastern time.

There are no registration fees for these webcasts on Neurobehavioral Issues Following TBI, but participants must sign up in advance.  Additional details, handouts and information on the program are available from NASHIA's web site www.nashia.org .  You can also get further information by contacting Nancy Kaywood, NASHIA Education Programs Manager at [email protected]

The program is done in collaboration with the Federal TBI Program at the US Department of Health and Human Services and the National Association of State Head Injury Administrators.  The goal of the program is to improve access to programs and services for persons with TBI and their families.

Cognitive Disability: Medicaid Information

Interested in a web site that explains Medicaid services that are available for people with cognitive disability?  Check out http://www.thedesk.info .

The Medicaid Reference Desk Site is an online resource that explains Medicaid for persons who have cognitive impairments as a result of brain injury in basic terms, state by state.  It provides individuals, family members and advocates for persons with brain injury including brain injury case managers, brain injury discharge planners, brain injury lawyers and brain injury care givers with what is available through their State Medicaid Plans and waivers.  The site also provides information on where to apply for services.

I have just learned that site is looking for stories from people with cognitive disabilities and family members about how they have used Medicaid to increase their independence.  They will collect written and recorded stories for use on http://www.thedesk.info .  If they use your story, you will receive a free T-shirt and $50.  If you have a story, send an e mail message [email protected] or call toll free at 1 877 431 8532

Mild Brain Injury: Important New Imaging Study

Brain Injury Lawyers who represent persons with a Mild Traumatic Brain Injury are often frustrated in Court because of the lack of "objective proof" confirming the brain injury.  CT scans and MRI scans are often negative in cases of mild traumatic brain injury, not because the brain wasn't injured, but because these imaging techniques have been incapable of detecting the microscopic injuries to the brain that take place.  It has often been said, lack of proof does not equate with proof of absence.

Recently newer imaging techniques and more powerful MRI machines have allowed the medical profession to detect brain lesions and brain damage which in the past could not be detected.  I have successfully used new imaging techniques such as PET scans, functional MRI's, diffusion tensor MRI studies and new and very powerful MRI scanners to detect brain injuries in my clients.

In the April issue of the American Journal of Neuroradiology a new study has been published which suggests that a finding on MRI images of enlarged perivascular spaces also known as Virchow-Robin spaces (VRS) is a radiological marker of mild traumatic brain injury.  The VRS space is a fluid-filled area surrounding arteries and veins in the brain. When the brain is traumatized, it is hypothesized that these spaces become inflamed.  The study examined 24 individuals who were diagnosed as having a mild closed brain injury but had negative imaging studies. New MRI images were obtained on each of the individuals using new imaging techniques.  The new MRI studies were then given to two neuroradiologists who were unaware that a diagnosis of Mild TBI had been established in these patients.  In each of these patients, enlarged VRS spaces were found to exist.  The full study is published in the American Journal of Neuroradiology, Vol. 26, pages 719-724 April 2005 and is entitled "Dilated Perivascular Spaces: Hallmarks of Mild Traumatic Brain Injury.  You can order this journal article from the American Journal of Neuroradiology by clicking here.