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Articles Posted in Brain Injury

Many Washington residents will incur a brain injury that requires a hospital stay. According to a pilot study done in the United Kingdom, older patients taking anticholinergics while in the hospital had longer recovery times if their anticholinergic drug burden levels were higher on discharge than on admission.

Anticholinergics are a class of drug used to treat various conditions, such as pain, depression, insomnia, and incontinence. It is well known that these drugs have side effects that include confusion, short term cognitive impairment, and dizziness. Fifty two patients with serious brain injury or spinal injury in a neuro-rehabilitation unit were studied because they are commonly given anticholinergics. This study suggests a link between ACB levels in the body and recovery time.

The side effects of the anticholinergic medication hinder the patient’s ability to fully engage in their rehabilitation, resulting in a longer stay in the hospital. One measure of a hospital’s performance is the length of the patient’s stay. The more time spent in the hospital, the higher the medical expenses, so financial considerations play a role in this. A co-author of the study says that when possible, anticholinergics should not be used in some people. A nurse, pharmacist, or doctor should regularly review the medication usage to ensure it is appropriate for each patient.

Parents in Washington may be interested in learning more about how pediatric brain injuries can manifest into a reduced attention span. Researchers have discovered that children diagnosed with traumatic brain injuries typically have slower reaction times and more attention lapses than children who have suffered trauma to other parts of the body. This is the first study to correlate pediatric TBI patients’ lapses in attention with attention or intelligence problems. The respondents who participated in the study were ages 6 to 13.

On average, after the 18 months following TBI, teachers and parents reported a higher rate of problems associated with externalizing, internalizing or maintaining attention in the children. The children tended to exhibit high anxiety or over-aggression. Pediatric researchers discovered that the respondents diagnosed with moderate to severe TBI suffered more lapses in attention and produced lower scores on their IQ test. Their condition may be described as TBI resulting in a loss of consciousness lasting over 30 minutes in conjunction with a bout of post-traumatic amnesia that lasts at least an hour.

Children with mild TBI also have more lapses in attention and lower IQ scores than the average student. These TBI victims may experience seizures, vomiting or a headache shortly after an injury occurs. Physicians say that once the attention issues last over a year, it’s unlikely that the situation will rectify itself without some intervention. For over a decade, researchers have known that TBI in children can result in “secondary ADHD.”

Emergency room physicians and neurologists in Washington now have a new tool at their disposal that may help them more accurately predict the outcomes of patients who have suffered from traumatic brain injuries. Researchers have developed a new diagnostic test that identifies a specific protein found in the brain that shows a fall in levels after a person has suffered a serious blow to the head.

After conducting studies of three different proteins that play a significant role in neurological cell activity, one distinct type, brain-derived neurotropic factor, was found in decreased amounts post cerebral trauma. Data suggests that the lowered supply of the protein coincides with the severity of the injury. Patients with moderate brain trauma presented with levels consistently 30 percent less than a control group, and individuals with severe injuries showed levels 15 times lower than normal.

Medical professionals are hopeful that the new blood test that identifies the specific protein will help physicians and auxiliary staff determine more relevant courses of treatment and reliable expectations for rehabilitation. The new test may also help researchers more accurately track medications and activities that help restore the protein during the recovery period.

Research done on mice with concussions could ultimately lead to a treatment for humans who are suffering from chronic traumatic encephalopathy. CTE is a progressive disease that is often seen in boxers or football players who routinely take blows to the head. By simulating mild and severe concussions in mice, scientists realized that CTE is caused by tangles in a brain protein called tau.

At first, they were not sure how these tangles occur. However, they believe that the tangles may begin as irregularly shaped tau proteins that may be eliminated with an antibody. The antibody would bind to the irregular protein and let the body know that it is an unneeded protein that should be cleared away. The findings may present a pathway to creating a drug that could help those who have CTE.

Scientists involved in the say that the next step is to humanize the mouse antibody, which could be done in the next couple of years. If successful, a new drug could stop CTE or brain damage after a major brain injury or even help to prevent Alzheimer’s Disease. Funding for the project was provided by the National Football League Players Association, the National Institutes of Health and the Alzheimer’s Association.

There are a variety of causes of brain injuries. The common thread that binds most of them together is the need for extensive medical care after the injury. For many Washington patients, that means long stays in hospitals or rehabilitation centers. While these patients often spend a lot of time in bed, a recent study suggests that these patients should get out of bed and start moving as soon as possible.

As part of the study, several hundred patients were followed after they had incurred a brain injury. More than half of those studied got out of bed as early as the first day when they were admitted into the intensive care unit. The study noted that the patients that got up and moving that early fared better than those who remained in bed for prolonged periods of time.

Some of the benefits noted included less time on the ventilator and fewer pressure sores for the patients who get moving faster. It isn’t always easy to get brain injury patients up and moving. In some cases, it can take multiple workers and considerable time to get the patient out of bed. Even then, if it is beneficial to get the patient up and moving, staff members should work to do just that.

Washington residents may be interested in a Stanford University study that examined the relationship between traumatic brain injuries and small hits to the brain. When the brain is bashed against the inside of the skull multiple times, the small injuries can have large cumulative effects. Unlike larger hits, however, they do not produce concussions. These injuries are common in contact sports such as football.

Every year, an estimated 1.7 million people in the United States sustain traumatic brain injuries. Of those, 80 percent are mild with no concussion. Severe external force trauma does not cause most mild traumatic brain injuries. Instead, these injuries most often result from the inertia of the brain as it collides with the skull after the head comes to an abrupt stop.

Researchers found that the typical rate of movement for normal actions, such as turning one’s head, is 5 hertz. The brain can be damaged at 15 hertz, and contact sports can cause it to move at 20 hertz. While concussive injuries occur in an instant, inertia-related brain injuries can happen multiple times over the course of a game. These injuries build up and cause cumulative brain damage as the brain rattles inside the skull. Researchers hoped that the findings could inform future protective helmets to prevent the brain from moving at dangerous speeds inside the skull.

Adults in Washington may acquire apraxia of speech after having a stroke or sustaining a traumatic brain injury. Apraxia of speech is a condition that affects a person’s ability to produce certain sounds. Although people who suffer from apraxia may be perfectly aware of what words sound like, their brains are unable to tell the right muscles how to move in order to say the words correctly.

Apraxia cases can range in severity, with the most severe cases causing people to be unable to produce any sounds at all. Most people with apraxia have a hard time producing certain sounds, so they either omit or substitute these sounds in their speech. A person with apraxia might have inconsistent speech errors and have an easier time producing automatic greetings than words that they are thinking about.

A speech therapist diagnoses a person with apraxia of speech by assessing their sound production, melody of speech and oral-motor abilities. Once this condition is diagnosed, an individual with apraxia might benefit from speech therapy that is designed to retrain their facial muscles. People with severe cases of apraxia might require alternative communication tools in order to function in their daily lives.

Washington residents may have heard a lot about traumatic brain injuries, or TBIs, in recent years. From the shooting of former U.S. Rep. Gabrielle Giffords to lawsuits over repeated concussions suffered by NFL players, TBIs have been all over the news.

The extra attention is helpful because the Centers for Disease Control reports that TBIs are a major cause of disability and death in the United States. In 2010, around 2.5 million emergency room visits, hospital stays or deaths were tied to TBIs, and the condition played a part in approximately 30 percent of all injury deaths in the country.

TBIs can occur due to a blow or bump to the head or a penetrating head injury, such as a gunshot wound, that interrupts a person’s normal brain function. TBIs can be mild, meaning a person may feel dizzy or briefly lose consciousness, or severe, meaning a person may be unconscious for a long period of time or experience significant memory loss. Most TBIs reported are mild and are referred to as concussions.

Washington residents may be interested to hear that the plaintiff in a personal injury lawsuit against Verizon was offered a $3 million settlement in July. The suit alleged that the driver of a Verizon-owned bucket truck was distracted at the time of the 2012 accident that caused the woman to suffer a traumatic brain injury. The woman, who had been a nurse for 32 years, was forced to leave her job as a result of her injury.

The accident occurred on Feb. 27, 2012, in Upper Darby, Pennsylvania. The Verizon truck rear-ended the plaintiff’s stopped vehicle on Garrett Road. The woman’s mild traumatic brain injury, which doctors and neuropsychologists agreed resulted from the collision, caused diminished cognitive function and memory loss. She also suffered from herniated neck and back discs that required surgery.

People who testified at the trial stated that the driver of the truck was using two cellphones at the same time as he approached the woman’s stopped car. He was on hold to speak with a Verizon employee with his personal cellphone while looking down at his business cellphone when he struck the woman’s car. Verizon settled the suit after court proceedings that lasted more than a week.

Late last month, President Obama organized a conference on the subject of sports-related concussions. We have previously discussed that these kinds of traumatic brain injuries may initially seem relatively harmless but can ultimately result in severe consequences. The media and safety advocates have been increasingly concerned about sports-related concussions for some time. It is a positive development that the White House has now taken significant executive notice of this public health and safety issue.

The attendees of the president’s conference included representatives from both the NCAA and numerous professional sports organizations such as the NFL. Professional sports team owners, physicians, members of Congress and scientists were also present in significant numbers. According to the New York Times, both public and private entities pledged tens of millions of dollars for education and research on sports-related concussions by the time that the conference concluded.

Many individuals are focusing on the fact that the conference was long overdue. And given the fact that sports-related concussions have harmed countless individuals, this concern is certainly understandable. However, it is also important to note that because the nation cannot change its past, it is critical that leaders remain unafraid to confront problems as they are manifesting right now. The conference may have been overdue, but the fact that it occurred at all is a positive development.

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