Traumatic brain injury, often referred to as TBI, has been christened the “signature injury” of the Iraq and Afghanistan wars. Thirty percent of soldiers taken to Walter Reed Army Medical Center since 2003 suffered traumatic brain injuries, according to the Defense and Veterans Brain Injury Center. The injuries are most commonly caused by shockwaves emitted from bomb blasts.

In January 2008, Congress ordered the tests, called Automated Neuropsychological Assessment Metrics (ANAM), be administered to troops before combat duty and again post-deployment. About 575,000 tests were administered on troops before deployment, but the follow-up tests were never given. In effect, the Pentagon has likely missed catching thousands of TBI cases.

Rep. Bill Pascrell, D-NJ, co-chairman of the bipartisan Congressional Brain Injury Task Force, called the Pentagon’s decision to shelf the tests “a total failure.”

“We’re failing to find TBI and post-traumatic stress disorder in an era when the military is trying to find and assist folks who need it,” Pascrell said.

Lt. Gen. Eric Schoomaker, the Army Surgeon General, barred post-deployment ANAM screening in November 2008. The tests were supposed to have run through a 5-year cycle until 2013. Schoomaker has said the tests are flawed and could easily yield false positives by the ingestion of medicines such as Benadryl and other substances and conditions.

Two military neurologists, Air Force Col. Michael Jaffee, director of the Defense and Veterans Brain Injury Center, and Cmdr. Jack Tsao, director of TBI programs for the Navy and Marines, told USA Today they disagree.

“Anything that would help us to better diagnose … servicemembers who may need further care or follow-up is welcome,” Tsao says.

Tresa Roebuck-Spencer, a neuropsychologist with the University of Oklahoma, which developed and distributes the testing program for the Army, said that Schoomaker’s assessment misrepresents the tests, which are intended only to signal a decline in soldiers’ thinking abilities and get them further evaluation and treatment. False positives drop significantly when the before and after tests are compared, Roebuck-Spencer said.

The ANAM tests take approximately 20 minutes to complete and cost $30 per case to administer. The computerized tests score reaction time, learning speed, short-term memory, mathematical processing, and other cognitive abilities. It also accounts for influencing factors such as mood, fatigue, and history of head injury.

Just 12,000 – 13,000 of the post-deployment exams have been conducted. If the Pentagon continues to bar returning troops from taking the exams, then the country will likely miss an enormous opportunity to advance diagnosis and treatment of TBI in all people.

SOURCE: Personal Injury Attorneys › Pentagon kills traumatic brain injury tests for combat vets

Traumatic brain injures

Because TBIs affect the most complex and least understood organ in the body – the brain – diagnosis and treatment often elude doctors, leaving patients to suffer from a lifetime of symptoms such as memory loss and forgetfulness, headaches, mood swings, depression, and even an exacerbation of secondary illnesses such as Post Traumatic Stress Disorder (PTSD).

In its quest to find better, more effective treatment for the veterans suffering from TBI, estimated to be more than 100,000, the Defense Department is taking a closer look at some methods that have shown promise but haven’t been thoroughly tested.

Pressurized hyperbaric chambers, which are used to alleviate carbon monoxide poisoning and decompression sickness, deliver 100 percent oxygen to patients under regulated amounts of atmospheric pressure. Theoretically, oxygen will travel through the body and repair damaged tissue, including damaged brain tissue. Studies conducted thus far on patients with TBI have been inconclusive.

The new Defense Department study will commence in January 2011 and will include approximately 300 soldiers and marines. The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and the Army Research and Materiel Command will lead the trial at Fort Carson (Colorado), Camp Pendleton (California), Camp Lejeune (North Carolina), Brooks City-Base, Texas, and Fort Hood, Texas.

Participants will sit in a hyperbaric chamber for one hour each day, five days a week for a total of 40 hours / sessions. Some will receive 100 percent oxygen and others in a control group will receive regular air.

Participants will include veterans who are undergoing a healing process from a TBI received 4-6 months prior to the onset of the test.

SOURCE: Personal Injury Attorneys › Hyperbaric chamber therapy may help heal brain injuries

Emory University in Atlanta has finished a small 100-person trial of the female hormone progesterone in patients who have sustained a TBI, and the results look promising.

Emory’s TBI trial was designed mainly to test the safety of the progesterone treatment. But doctors not only found that the hormone had no serious side effects on patients, they discovered that the patients who had received the hormone rather than a placebo were much more likely to recover from their brain injury.

Additionally, patients who received progesterone were half as likely to have died from their injuries than the patients who received placebo. Among the survivors, the patients who had received progesterone were less disabled and some even made a complete recovery.

Doctors involved with the study and other medical experts are especially excited about the outcome because, as Arthur Kellerman, chairman of emergency medicine at Emory, told USA Today, “every single clinical trial of a treatment for brain injury has failed.”

A similar Chinese study, conducted about the same time but completely independent, bolstered Emory’s findings. The study conducted in China among 159 TBI patients found that those who received progesterone treatments were less likely to die and recovered faster and better than those who did not receive the hormone.

The National Institutes of Health has taken notice of the Emory trial and is financing a larger study of 1,240 TBI patients to the tune of $15 million.

More than 1.5 million people suffer from traumatic brain injuries in the U.S. Among those, more than 50,000 die. Today, more than 5 million people suffering the debilitating impairments from TBI require assistance with their daily activities, according to the Centers for Disease Control and Prevention.

TBI has also been called the “signature injury” of the Iraq and Afghanistan Wars. So far, more than 360,000 troops have returned home with TBI. Up to 25 percent of those injured soldiers experience persistent symptoms and will require long-term care.

Researchers say that sometimes male patients and their families are dubious about receiving progesterone, which is extracted from yams at little expense, because it is commonly associated with females. However, Kellerman told USA Today that progesterone would be more accurately described as a “protection hormone” because of its proven abilities to heal when the body becomes injured.

Doctors begin enrolling patients in the new TBI study this week. The study is expected to last up to four years because logistically that’s how long it will take to get enough patients. The study’s leaders are confident that the results will become known much sooner.

SOURCE: Personal Injury Attorneys › Hormone may hold key to brain injury recovery

A Peoples Gas representative told the Frankfort Station newspaper that the incident did not involve an explosion and no natural gas was involved as far as the company could tell.

Witnesses told the Frankfort Station that they heard a loud pop, followed by dust billowing into the street.

“I was about 20 feet away from the hole when it blew, and there was a big cloud of dust and I noticed a construction helmet came flying out of the hole,” Kevin Spillers, who was standing across the street from the accident when it happened, told the Frankfort Station.

Spillers, who works as a trader at the Board of Trade in Chicago, jumped into the hole with a Peoples Gas employee and found Gryga laying on the ground unconscious but breathing. Grygas was covered in a few inches of sand. Another worker who was in the hole at the time of the accident was alert but bleeding and stunned.

“We uncovered [Gryga] and just sat with him and kept telling him to breathe,” Spillers told the Frankfort Station. “He was breathing very comfortably, and he was very calm … it was just like he was asleep.”

Sadly, Gryga’s breathing gradually slowed and stopped by the time fire trucks arrived, about 10 minutes after the accident.

Gryga, who was a father of high school twins, volunteered as an assistant coach of a local softball team. He was described by a fellow coach as “a good dad and a hard worker” who was always trying to get overtime pay with the gas company to provide for his family.

The accident remains under investigation.

SOURCE: Personal Injury Attorneys › Pressure test kills one Chicago gas worker, injures another

The campaign, which launches this month, will be coordinated through the BIAA’s 44 chartered state affiliate groups. The organization plans a spectrum of public service announcements and awareness proclamations, which will appear in print and on the radio throughout the country. A number of special events will also take place throughout the year.

BIAA will also begin actively advocating for legislation designed to teach athletic coaches about the seriousness of concussions and train them on how to prevent, recognize, and handle concussions when they do occur. The organization believes that “coaches of every school athletic team and every extracurricular athletic activity” should know about brain injury, including concussions and second impact syndrome.

“BIAA also believes young athletes who appear to have sustained a concussion should have written authorization by a health care professional before returning to play, “ the organization’s website says.

Concussions are caused by a bump, blow, or jolt to the head or a blow to another part of the body that has an indirect impact on the head. Because concussions can occur without a loss of consciousness, they are often underestimated. According to the Centers for Disease Control and Prevention, concussions that are not properly diagnosed or managed may lead to serious complications including coma and death.

The signs and symptoms of coma include nausea, dizziness, lack of balance, double or fuzzy vision, sensitivity to light or noise, headache, sluggishness, fatigue, feeling foggy or groggy, confusion, difficulty concentrating, and memory problems. These signs may appear immediately after the concussion occurs or they can take days or weeks to become noticeable.

In the U.S., 3.8 million concussions occur each year as a result of sports and recreation activities. Emergency room physicians treat approximately 135,000 traumatic brain injuries (TBIs), including concussions, in children ages 5 to 18 every year.

Concussion facts

• A concussion is the most common type of brain injury sustained in sports.
• Most concussions do NOT involve loss of consciousness.
• You can sustain a concussion even if you do NOT hit your head. An indirect blow elsewhere on the body can transmit an “impulsive” force to the head and cause a concussion to the brain.
• Multiple concussions can have cumulative and long lasting life changes.
• Concussions typically do NOT appear in neuroimaging studies such as MRI or CAT Scans.
• An estimated 1.6-3.8 million sports- and recreation-related concussions occur in the United States each year.
• During 2001-2005, children and youth ages 5–18 years accounted for 2.4 million sports-related emergency department (ED)
  visits annually, of which 6% (135,000) involved a concussion.
• Of the 1.4 million traumatic brain injuries sustained by children and adults in the United States each year, at least 75% are mild and/or concussions.
• Among children and youth ages 5–18 years, the five leading sports or recreational activities, which account for concussions, include bicycling, football, basketball, playground activities, and soccer.

SOURCE: Personal Injury Attorneys › March is brain injury awareness month, concussions take spotlight

Julia suffered a broken nose, broken facial bones, and a broken leg in the accident, but avoided a traumatic brain injury and was able to go home after five days of treatment in the hospital. Dr. Michael McGonigal, the director of trauma services at Regions Hospital in St. Paul, told Minnesota Public Radio that Julia was very fortunate to be wearing a helmet.

“It protected her brain, and that’s something that we can’t really fix, unfortunately. The helmet kept her in perfect condition, so she is fine other than a few things that will heal up now with a little extra care,” Dr. McGonigal told MPR.

Julia told reporters that the accident taught her one thing: to wear a helmet – something she and her 2 siblings have always done, thanks to their parents.

Helmets are not legally mandatory for skiers and snowboarders in the United States, although some resorts and recreational parks have their own rules governing the use of protective head gear.

According to the National Ski Areas Association, only 48 percent of all skiers and snowboarders wear helmets. That may seem like a grim figure, but helmet use on the slopes has actually doubled in the last decade.

Fortunately, most parents are raising their children to wear helmets while skiing. Seventy-seven percent of children 9 and younger and 66 percent of children ages 10 to 14 wear helmets when they ski.

Dr. McGonigal suggested that parents get their children involved with wearing skiing helmets at an early age. Julia told MPR that she doesn’t mind wearing a helmet because it keeps her head warm.

SOURCE: Personal Injury Attorneys › ski helmet saves minnesota girl from brain injury

Toyota

Previously we have reported on this web site that some of the drivers who became caught in a runaway car were unable to remedy the situation. There’s the story of Bulent and Anne Ezal, whose 2005 Camry accelerated unintentionally in the parking lot of a Pismo Beach, California, restaurant, causing the vehicle to plunge off a cliff and killing Anne. Shortly after that February 2007 accident in Pismo Beach, Jean Bookout lost control of her 2005 Camry as it sped off an Oklahoma interstate. Attempts to stop the vehicle were unsuccessful. Jean’s friend Barbara Schwarz was killed when the car hit an embankment, and Barbara spent months in the hospital with serious head and back injuries.

Another unintended acceleration incident, which happened just this past August, found off-duty California Highway Patrol officer Mark Saylor careening down a San Diego County highway at speeds topping 120 mph, according to witnesses. Saylor never could gain control of the Lexus ES 350. The car crashed, killing Saylor and his wife, daughter, and brother-in-law.

Likewise, Guadalupe Gomez couldn’t regain control of his 2007 Camry as it raced uncontrollably down a busy San Jose freeway at speeds of more than 100 mph. Gomez tried everything he could think of to stop the vehicle, but nothing worked. Gomez’s Camry struck a Honda Accord, killing a California father of 5 – an accident for which Gomez was arrested and sued.

Of course, it’s difficult to tell for certain whether the floor mats were solely to blame for these accidents. There are other reports of unintended acceleration in Toyota vehicles that are not easily pinned on a floor mat problem. While Toyota investigates the problem, it urges drivers of the affected Toyota vehicles to drive without floor mats.

However, Toyota realizes that not all consumers will choose to drive without the mats. In its announcement, Toyota gives instructions on what to do if a driver is caught in an unintended acceleration situation:

• First, if it is possible and safe to do so, pull back the floor mat and dislodge it from the accelerator pedal; then pull over and stop the vehicle.
• If the floor mat cannot be dislodged, then firmly and steadily step on the brake pedal with both feet. Do NOT pump the brake pedal repeatedly as this will increase the effort required to slow the vehicle.
• Shift the transmission gear selector to the Neutral (N) position and use the brakes to make a controlled stop at the side of the road and turn off the engine.
• If unable to put the vehicle in Neutral, turn the engine OFF, or to ACC. This will not cause loss of steering or braking control, but the power assist to these systems will be lost.
• If the vehicle is equipped with an Engine Start/Stop button, firmly and steadily push the button for at least three seconds to turn off the engine. Do NOT tap the Engine Start/Stop button.
• If the vehicle is equipped with a conventional key-ignition, turn the ignition key to the ACC position to turn off the engine. Do NOT remove the key from the ignition as this will lock the steering wheel.

More information about the recall and floor mat installation can be found on http://www.toyota.com.

SOURCE: Personal Injury Attorneys › What should you do in a car that speeds out of control?

The CPSC estimates that 16,300 children age 5 and younger received treatment in emergency rooms for injuries caused by TV, furniture, and appliance tip-overs in 2006 alone. 134 tip-over related deaths were reported to the CPSC between 2000 and 2006, and the agency “is aware of at least 30 media reports of tip-over deaths since January 2007 involving this same age group.”

Children are frequently injured or killed when they attempt to pull themselves up, climb onto, or fall against objects such as television stands, bookshelves, dressers, desks, chests, and appliances. Televisions sitting on top of furniture often tip over, resulting in sometimes fatal injuries, the CPSC reported.

“The most devastating injuries that we see resulting from furniture tipping on children are injuries to the brain and when a child is trapped under a heavy piece of furniture and suffocates,” said Gary Smith, MD, DrPH in the CPSC report. Dr. Smith is director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.

Inez Tenenbaum, who championed child safety and advocacy issues before President Obama appointed her CPSC Chairman, stressed the importance of securing heavy objects in homes where young children are present. “Many parents are unaware of the deadly danger of this hidden hazard. I urge parents to include securing TVs, furniture, and appliances in their childproofing efforts. Taking a few moments now can prevent a tip-over tragedy later,” she said.

The CPSC issued the following tips on preventing tip-over injury and death:

• Furniture should be stable on its own. For added security, anchor chests or dressers, TV stands, bookcases and entertainment units to the floor or attach them to a wall.
• Place TVs on a sturdy, low-rise base. Avoid flimsy shelves.
• Push the TV as far back as possible.
• Place electrical cords out of a child’s reach, and teach kids not to play with them.
• Keep remote controls and other attractive items off the TV stand so kids won’t be tempted to grab for them and risk knocking the TV over.
• Make sure free-standing ranges and stoves are installed with anti-tip brackets.

Additionally, the CPSC said that it recently revised the warning labels attached to children’s furniture about the tip-over risk. Additional hardware will be provided with certain pieces of furniture to secure furniture to the floor or wall.

To see the entire statement or watch a video produced by the CPSC, visit the CPSC’s website.

SOURCE: Personal Injury Attorneys › CPSC urges parents to prevent child injury and death

According to the Los Angeles Times, the accident happened around 7:19 p.m. during a routine rope swing drill at the UC San Diego campus. Reports say that Roach was unresponsive and stopped breathing immediately after the accident occurred. He was transported to emergency medics to Scripps memorial Hospital in La Jolla, where doctors treated him for TBI.

Sadly, Roach’s doctors declared the athlete brain dead on Saturday, September 5, at about 5:00 p.m.  UC San Diego expressed its condolences in a statement it released after Roach’s death. “Words cannot begin to express our sorrow. Our hearts go out to the family and friends of this remarkable student and valued member of the UC San Diego community.”

A report in the Orange County Register said that pole vaulting ran in Roach’s family. “Roach … graduated last year from Marina High School and came from a family where pole vaulting was a tradition. His father, Leon Roach II, was involved in the sport in college, and his older brother, Curtis Hendrick, was also a success at Marina.”

According to the Brain injury Resource Center, approximately 1.4 million Americans sustain some form of TBI every year, 300,000 of which received the injury when playing sports. 1.1 million people are treated for concussion and released from the emergency department, but 235,000 require hospitalization and approximately 50,000 die as a result of their brain injury.

SOURCE: Personal Injury Attorneys › TBI kills UC San Diego pole vaulter

Time, money, and x-ray radiation considered, it would be both unhealthy and nearly impossible to rush one’s children to the hospital for a CT scan every time they bump their heads. So is there a way to distinguish a simple bump from a serious head injury?

Researchers in the United States say than an analysis of more than 42,000 children with head injuries has helped uncover some guidelines to identify those who are at low risk for traumatic brain injury.

Of the tens of thousands of children examined, less than one percent (376) had some form of TBI, and of those, 60 had to undergo neurosurgery.

According to an article published in U.S. News & World Report, citing a study published in the medical journal The Lancet, there are visible signs that indicate whether children have a “clinically important” TBI. In children under two years old, “safe” signs are: “normal mental status, no scalp swelling except frontal, no loss of consciousness or unconscious for under five seconds, non-severe injury mechanism, no noticeable skull fracture, and parents reporting normal behavior in the child.”

“Using these guidelines, the researchers accurately predicted 100 percent of 1,176 patients who didn’t have clinically important traumatic brain injury,” the U.S. News report noted. “Among children under age 2 in this low-risk group, 24 percent received a CT scan,” according to the researchers cited in the article.

For children ages 2 to 18 years, the screening characteristics include: “normal mental status, no loss of consciousness, no vomiting, non-severe injury mechanism, no signs of basilar skull fracture, and no severe headache.”

According to the report, doctors correctly identified those children 2-18 years old without a clinically significant TBI using these characteristics in 99.95 percent of the cases.

The study’s author, Dr. Nathan Kupperman of the University of California, Davis Medical Center in Sacramento, said that “Using these clinically important traumatic brain injury prediction rules could have avoided the use of CT scans and resulting radiation exposure in 25 percent of children younger than 2 years old and in 20 percent of children older than 2 years.”

The full study may be viewed in the latest edition of The Lancet.

SOURCE: Personal Injury Attorneys › Research helps identify injured children at low risk of TBI

According to Clemson, the material “has the potential to spur the growth of a patient’s own neural stem cells in the body, structurally repairing the brain injury site.” In previous lab studies conducted with rats, Zhang demonstrated “the reconstruction of a complete vascular network at the injury site as an initial step toward brain tissue regeneration,” the university said.

Zhang’s findings, supported in part by a $220,000 grant from the U.S. Department of Defense, provide hope for the growing number of American veterans returning from Iraq and Afghanistan with traumatic brain injuries, considered by many medical and military professionals to be the “signature injury” of the wars in Iraq and Afghanistan. Zhang presented her research last week at the Military Research Forum in Kansas City. The purpose of the conference is to further improve the health and welfare of all American armed forces, their families, and the public at large.

“We have seen an increase in brain injuries due to combat, but our strategy can also potentially be applied to head injuries caused by car accidents, falls and gunshot wounds,” said Zhang.

Pentagon officials estimate that as many as 360,000 Iraq and Afghanistan veterans have suffered from combat-related brain injuries. Some 45,000 to 90,000 veterans have TBI symptoms that persist and require special care.

“These results that we are seeing in adult lab rats are the first of its kind and show a sustained functional recovery in the animal model of TBI,” Zhang told the conference. “It also represents one of very few in the traumatic brain injury field that attempts structural repair of the lesion cavity using a tissue-engineering approach,” she said.

According to Zhang, traditional TBI treatments, which often involve the use of drugs, have had limited success. With the new procedure, gel would be injected into the brain at the site of the injury “to direct the response of neural stem cells in the brain to regenerate normal brain tissue at the lesion site,” according to Clemson’s announcement.

Zhang says that the new procedure could be ready for human testing in about three year’s time.

SOURCE: Personal Injury Attorneys › Clemson research offers hope for TBI patients

Shenai McLorn believes that her son Demond’s football coach, Darren Sunkett, ignored the potential for injury by providing her son with a defective football helmet and ordering him to play without protective gear. As a result, Demond experienced a number of seizures and strokes while sitting on the sidelines at a game last October.

According to a report by the St. Louis Post-Dispatch, McLorn claims her son, who plays football at East St. Louis High School, suffers from serious and permanent head injuries as a result of the coach’s and school district’s negligence. She seeks more than $200,000 in compensation for Demond’s injuries, which required him to be hospitalized for several weeks. Doctors who operated on Demond found that he suffered from a ruptured blood vessel inside his brain.

McLorn’s lawsuit says that the protective cushion inside her son’s helmet was not properly inflated. It also says that Sunkett ordered Demond to play even after he complained of a headache and showed signs of concussion.

The lawsuit also asserts that Sunkett “ridiculed and sought to embarrass student-athletes who suffered injuries, thus creating an atmosphere where injuries were not reported or under-reported.”

According to the Post-Dispatch, a few weeks before Demond’s hospitalization, Sunkett ordered Demond to practice tackling even though he and another player weren’t wearing safety gear. Demond broke his collar bone in the incident. The other player broke his neck.

Playing sports is the leading cause of concussion and other brain injuries in children. Contact sports are especially dangerous when played without a helmet and other protective gear. According to the Brain Injury Association of America, multiple concussions can have cumulative and long lasting effects on a child’s life. About 1.4 million children receive a traumatic brain injury of some degree every year. Football, bicycling, basketball, soccer, and playground activities account for most of the brain injuries children receive.

SOURCE: Personal Injury Attorneys › Illinois mom says negligence led to her son’s brain injuries

When he was well enough, Bullock was transferred from the University of Oklahoma Medical Center in Oklahoma City to the Children’s Center in Bethany, Oklahoma. There, Bullock lived for the next two years as doctors and therapists worked vigorously to rehabilitate him. Even the most basic functions – talking, walking, eating – had to be relearned.

Although Bullock remained largely unresponsive to all of his therapies, Children’s Center staff persisted. They worked closely with him in a slew of therapies including physical, speech, educational, recreational, and others. One therapy, however, seemed to strike a chord with Bullock more than any other: musical therapy.

After six months of barely any visible improvement, Bullock’s condition suddenly turned around. He began to improve dramatically as if determined to reclaim all of his lost abilities once and for all.

Tami Crawford, one of Bullock’s therapists, told The Oklahoman about the Children’s Center’s rehabilitation efforts for Bullock. According to Crawford, following the patient’s leads and customizing therapy sessions is essential to recovery.

“We made up our own rehabilitation and turned physical therapy into games,” she told the paper.

“It’s all about thinking outside the box — working with the patients themselves about what they want and can actually do.”

When therapists saw that Bullock was especially favorable to musical therapy, they established a course of treatment for him. Bullock enthusiastically participated in the musical therapy sessions and began singing even before he reclaimed his ability to talk.

Megan Long, a music therapist who worked with Bullock, said that music rehabilitates and lights up the whole brain. “Music is a full-brain function. If you have brain damage in one part of the brain, we can still use music to retrain that other side of the brain because music appears all over the place,” she told The Oklahoman.

“If the language portion of your brain is damaged, you may lose the language. But with music, you could still sing,” Long explained.

Suddenly, the spark of life that people recognized as Bullock, the boy they remembered, reappeared. The happy-natured boy everybody knew as a jokester came back. Bullock even beat celebrity Mark Harmon in a drumming competition at the hospital, holding the beat longer than the NCIS actor.

Bullock moved back home after living at the Children’s Center for two years, and was determined to give back to the hospital that aided his recovery so much. Now an Eagle Scout and a junior in high school, Bullock works on ways to improve playgrounds at the Children’s Center and elsewhere – a civic duty that gives him a vast amount of joy. He also completed a two-mile Walk to Cure Diabetes course with his parents.

“Even with his medical hardship, he has the spirit of giving back,” Brian Dougherty, landscape architect for the Children’s Center, told The Oklahoman.

Routine has also played a key role in Bullock’s recovery. His parents help him stick to an exercise program every day.

“With the brain injury, structure is very important to him as there can be memory and cognitive difficulties if he doesn’t stick to a schedule,” Aaron’s mother, Mirka Bullock, told The Oklahoman.

“It must go in order — he is in a summer program now, goes to school every day, rests when he gets home, works on stretching and moving up and down from the floor,” she said.

Lori Boyd, vice president of special projects at the Children’s Center told The Oklahoman that Bullock “has been one of those miracle children to watch.”

“When he came in, we didn’t know what the prognosis would be. And then to see him go from a brain-injured state to being able to walk out of here — that’s one of those miracle things and really shows his dedication to the treatments.”

SOURCE: Personal Injury Attorneys › Teenager’s miraculous comeback provides hope for TBI patients

Weeks after being released from the ICU in Montgomery, Jason grew increasingly and uncharacteristically depressed. He knew something must be very wrong, that maybe the doctors had overlooked something. Carol, a resident of Montgomery, Alabama, finally took her son to see a neuropsychologist, who uttered the words “traumatic brain injury” for the first time. Carol had never heard of TBI before, so she began seeking answers.

Unfortunately, Carol seemed to get only more questions. Why didn’t Jason’s doctors find this TBI? Why did they send him home with a serious brain injury? Didn’t they at least know to look for brain trauma, especially after such a violent physical assault to the head? If the doctors don’t know about TBI, who does?

By connecting with other victims of TBI through the Alabama Head Injury Foundation (AHIF), a support group for TBI patients and their families, Carol realized that there was a dangerous lack of knowledge and resources in her state.

“What I found is that we’re all in the same boat. We all have bits and pieces of information about TBI because we want to know what our loved ones are going through. We research and we advocate, but there is not one, central place to go for information about TBI,” Carol said.

The lack of TBI awareness extends throughout the medical system itself, Carol said. Her own frustrating experiences in dealing with TBI were echoed by many people she met in a recent AHIF support group meeting.

According to Carol, one prominent government official from Montgomery was visiting Chicago when his wife fell down a flight of stairs and received a serious head injury. “I am completely convinced my wife would have died had this happened in Montgomery,” the man told Carol, thankful that his wife’s accident occurred in a city known for its TBI research and treatment programs.

The lack of TBI awareness, especially throughout the medical community, is not confined to Montgomery or even to Alabama. It’s a serious problem everywhere, as actress Natasha Richardson’s brain injury demonstrated so publicly earlier in the year. After hitting her head in a skiing accident, Richardson just wanted to go back to her hotel room to rest. Neither she nor the emergency personnel who initially treated her thought the injury would involve a fatal TBI until it was too late.

Nor do TBI survivors really know what they are up against. Carol asked one man at the AHIF meeting what his TBI experience was like. The man sustained his injuries in a motorcycle accident. Carol asked him if he suffered from depression and anxiety like her son Jason, who developed the symptoms a couple of months after the assault. The man told Carol that yes, he did struggle with the same symptoms. However, he never realized they were a direct result of his brain injury.

“It’s really unfortunate that we have to get all of our information from other victims of TBI and their family members at the support group,” Carol said.

TBI is a leading cause of death and disability in the U.S. Every year, more than 1.5 million Americans receive a TBI. To date, two percent of the U.S. population – some 5.3 million Americans – live with disabilities caused by their TBI. 1,500 Alabamians are disabled every year because of TBI injuries.

Although some progress is being made with TBI awareness, Carol believes we have a long way to go.

“When I walked into the AHIF meeting, what I found was unexpected. All walks of life, all different stages and degrees of TBI. Some family members were there. Some patients were there, young and old. Car and motorcycle wrecks, near drowning, accidents, physical assault, ” Carol said.

“All of this is going on but there’s not enough information and resources consolidated in one place,” she said.

Not including war injuries (TBI is considered the “signature injury” of returning Iraq and Afghanistan veterans), vehicle crashes account for half of all TBI cases in the U.S. Falls account for 21%, followed by violent assault at 12% and sports or recreational injuries at 10%.

SOURCE: Personal Injury Attorneys › Lack of awareness, resources haunt brain injury victims

The report cites a 2007 study of 767 traumatic brain injury patients in the UK. Research published in the Oxford journal Brain indicated that TBI sufferers were twice as likely to die as the general population seven years after their injury.

Results of a similar study that monitored 2,178 patients in 2004 and released by the Institute of Medicine showed that people with moderate to severe TBI had a lower life expectancy by as much as nine years.

Given the elusive nature of TBI and the brain itself, neither study could conclude with certainty that the premature deaths were related to TBI. According to one doctor cited in the ABC report, the longer a patient survives after a TBI, the more their risk of a premature death decreases.

Still, though, the death of a 26-year old Colorado man illustrates the most poignant fears of the destruction TBIs can have years after they were received. Timothy Whalen was 18 years old when he was struck on the back of his head following an altercation he had with another teenager near the University of Colorado’s Boulder campus.

Nine years after the incident, Whalen died suddenly. There were no obvious signs as to what caused his death. Results of Whalen’s autopsy aren’t expected for several more weeks, but some doctors and researchers believe that TBI could be the ultimate culprit.

Seizures, for instance, affect at least 30 to 40 percent of TBI patients receiving treatment in ICU and can occur, seen or unseen, years after the injury. In some cases, the seizures can lead to death by cardiac arrest or a closing of the air passages.

SOURCE: Personal Injury Attorneys › Research suggests brain injuries may shorten lives

Riddle’s experience illustrates how the symptoms of TBI can vary dramatically between victims, depending on which of the brain’s structures have been damaged. The degree to which a TBI victim recovers is also highly variable and largely unpredictable. Riddle has no memory of the time between the day of her accident until August 25 – the day, as she said, that her “brain just turned on.”

After emerging from her coma, Riddle changed hospitals and began intensive therapy, relearning basic tasks such as talking, walking, and brushing her teeth. But she remembered none of it.

By mid-September, Riddle recovered enough to go home. She feels fortunate that her recovery was so rapid. Mostly, however, she is grateful that her cheerful disposition and positive attitude remained intact.

“A lot of people with TBI (traumatic brain injury) have real anger issues that come out,” she told BE Healthy.

Although speedy, Riddle’s recovery was not 100 percent. Many years after the accident, Riddle still has not recovered peripheral vision on her left side. Because of her vision loss, Riddle’s driver’s license doesn’t permit her to drive beyond a 10-mile radius of her home. She relies heavily on family to take her to places she wants to go. She can’t see tree branches on her left side and gets hit in the head frequently when she’s out walking her dog.

Facial recognition is her other lingering problem. Riddle easily recognizes the people she knew before the crash. When she meets new people, however, remembering them later isn’t an automatic process. She has to carefully observe hairstyles, facial features, and other characteristics.

According to the Center for Disease Control and Prevention (CDC), approximately 1.4 million Americans suffer from TBI every year. TBI is also responsible for about 50,000 deaths in the U.S. every year.

The number of people in the U.S. living with TBI is widely estimated to be between 2.5 million and 6.5 million. Many common cases of TBI occur every day but often go unreported and untreated.

To listen to Susan Riddle’s tell her story, click here.

SOURCE: Personal Injury Attorneys › years after accident, TBI victim suffers but hasn’t lost her spirit

PTBI is to blame for 5,000 deaths and about one million hospitalizations every year. Of the pediatric patients hospitalized for PTBI, 17,000 result in permanent disabilities.

The Sarah Jane Brain Project is actively building a network of hospitals and research clinics across the country as part of its National Pediatric Acquired Brain Injury Plan. Each state will have one lead center. UAB’s Division of Pediatric Rehabilitation Medicine and its clinical practice at Children’s hospital will coordinate the project for the state of Alabama.

Patrick B. Donohue established the Sarah Jane Brain Project in 2005 after a nurse shook his 5-day old daughter at their New York City home. The incident left Sarah Jane Donohue with 2 broken collar bones, 3 broken ribs, and a severe brain injury. The injuries went undiscovered for more than a week until Sarah Jane’s parents suspected something was wrong. They returned to Lenox Hill Hospital, where Sarah Jane was born, with a child who was unable to eat or cry. Days later, doctors discovered the horrible extent of her injuries. Sixty percent of Sarah Jane’s rear cortex was lost.

As a result of her injuries, Sarah Jane lives in a constant state of physical and rehabilitative therapies. She is unable to sit, crawl, or walk without assistance, she is unable to speak, read, and understand words, and she cannot eat solid foods. Sarah Jane requires round the clock care and attention.

The Sarah Jane Brain Project’s mission, to create a model system for children suffering from all Pediatric Acquired Brain Injuries, was born out of Donohue’s frustration over a lack of consolidated resources and information about PTBI.

“As a father of a child suffering from PTBI, I have spent countless hours searching the internet and speaking with [Sarah’s Jane’s] … doctors, therapists and other professionals trying to improve the development of my daughter, Sarah Jane,” Donohue says on the Project’s website.

“Whereas, there are a countless number of wonderful and informative prevention sites for Shaken Baby Syndrome and advocacy sites for Traumatic Brain Injury and other Pediatric Acquired Brain Injuries (PABI), there isn’t a central resource for research, rehabilitation and development for PABI,” Donohue said.

SOURCE: Personal Injury Attorneys › Birmingham hospital leads Alabama in pediatric brain injury care

According to two UCLA professors who quantified nearly 20 years of data from TBI studies, childhood brain injuries may affect the individual long-term or even permanently. The impact of TBI on these individuals turned out to be worse than expected. The study showed that children and adolescents who suffered from a severe TBI fell further behind their peers than the researchers expected.

Doctors typically measure the severity of a TBI with the Glascow Coma Scale (GCS), which measures the patient’s eye and pupil response, motor responses, and verbal communication skills. In the UCLA study, researchers examined all three levels of TBI – mild, moderate, and severe – and conducted follow-up exams that tested more than a dozen neurocognition features.

The study revealed that the more severe the TBI, “the worse the neurocognitive outcome over time, especially on measures of general intellectual functioning and brain processing.”

The study also showed that children with TBI experienced a moderate level of recovery with intellect and attention, but that difficulties lingered even two years after the injury. Even after two years, children with severe TBI showed “significant problems” with their IQ, mental processing speed and attention, and immediate and delayed verbal memory.

“The good news is that the studies showed that children with mild traumatic brain injuries and concussions may show some difficulties in cognition initially, but the effects are subtle and typically diminish over time,” said Talin Babikian, the study’s lead author.

She also noted that a child’s age at the time of the TBI is an important factor because younger children have more developmental time ahead of them. Mental performance can be greatly impeded by a TBI, so younger children who sustained severe TBI generally fared worse than older, more mentally developed children.

According to Babikian, one important lesson to take away from the study is the importance prevention and protection. “The public health implication of this research is a reminder of the importance of the use of protective measures to minimize the effects of a brain injury, when one does occur, as well as prevention through consistent use of helmets and seatbelts,” she said.

SOURCE: Personal Injury Attorneys › UCLA study examines lasting effects of severe TBI in children

Traumatic brain injuries

Because the brain is the human body’s most complex and least understood organ, brain injuries have historically eluded diagnosis and treatment. Fortunately, our understanding of TBI, the “signature injury” of the Iraq and Afghanistan wars, is rapidly improving.

Members of the Air Force, Army, Marines, and Navy are now required to take mandatory brain tests that measure cognitive skills. Troops who are deployed to war zones retake the brain tests when they arrive home after a tour of duty, and those results are compared to the original test results.

Senators Bill Frist (R-TN) and Barack Obama (D-IL) worked together to pass an amendment that ensures all returning service men and women are tested for TBI. As President, Obama is expected to increase funding for the diagnosis and treatment of TBI in veterans.

The latest studies estimate that about 360,000 men and women have returned from the conflicts in Iraq and Afghanistan with some form of brain damage. Slowed thinking, memory loss, sleep disturbance, attention and concentration deficits, depression, and irritability are some of the most common signs of TBI. Many veterans also suffer from Post Traumatic Stress Disorder, which typically exacerbates the symptoms of TBI and vice versa.

Six new TBI clinics have opened in military bases around the country and many more are being built, allowing veterans better access to treatment of TBI. Army Col. Rachel Armstrong, who oversees the TBI testing program, said that the goal is to have a brain injury specialist at every U.S. military installation. The brain injury center at Fort Campbell, which opened last September, has tested 400 returning soldiers for TBI. Fifteen percent of those soldiers are being treated for brain injuries.

Source: http://www.msnbc.msn.com/id/30135396/

SOURCE: Personal Injury Attorneys › Traumatic brain injuries become a priority in U.S. military

Many people who receive a serious brain injury do not know it, which is precisely why Jason’s mother, Carol Stanley, says it’s so important to raise awareness of TBI.

“Most people seem to think ‘oh, it’s just a bump or a cut on the head. Give it a couple of weeks and it will be fine,’” Carol said.

“Wrong,” she added. “You are not the same person you were before the head trauma.”

Carol’s concerns about the seemingly innocuous nature of a “bump on the head” is evidenced by the tragic events surrounding actress Natasha Richardson’s death. Richardson hit her head while skiing in Canada last month, but she talked and behaved normally and refused medical treatment. Hours later, back at her hotel room, she developed a headache and was taken to the hospital, where she arrived in critical condition. Richardson died the following day.

Since news of Richardson’s injury and death, many people have taken those mere bumps on the head a little more seriously, including the parents of one 7-year-old Ohio girl. After getting hit in the head by a baseball, she would have died of the same injury as Richardson had her parents not read the news and recognized the headache their daughter developed.

Just as Natasha Richardson’s story has helped raise awareness of TBI, so have the reports about Jason Stanley that have appeared in local media.

“Since Jason’s story has been in the newspapers, family, friends, etc. have been calling and telling me they had no idea Jason’s injuries were so serious,” Carol Stanley said, explaining that oftentimes people with TBI can look, act, and talk normally.

“That is another reason for TBI awareness,” she said. “Most people don’t know about TBI and what causes them. Nor do they know what the long-term health problems of TBI are. This information can help people. It can help prevent injuries and it can help save lives when someone does receive an injury.”

Carol said that one woman contacted her just hours after one story about Jason ran in the newspaper. The woman’s husband had received two broken legs and brain trauma in a car accident more than a year ago, but still suffers from the same problems as Jason. The woman was frustrated with the care her husband received by doctors who didn’t seem to understand the sometimes subtle nature of a severe head injury.

Another Alabama family whose 17-year-old daughter also sustained severe head injuries in a car accident read Jason’s story in the local paper and wanted to meet Carol so they could learn more about TBI. Sadly, however, their daughter passed away just days after the article ran.

Carol credits UAB neuropsychologist Dr. Thomas Novak with helping her and Jason navigate the complicated labyrinth of TBI. Dr. Novak is nationally recognized for his research involving TBI patients and their recovery.

People who have TBI or know someone who has TBI can find a number of resources by going to UAB’s Traumatic Brain Injury Clinic website.

SOURCE: Personal Injury Attorneys › Traumatic brain injury: Jason’s story part five

It’s not going to be done unless there’s a voice out there. Someone who is out there making sure it gets done,” said Carol, expressing her frustration over the seriousness of TBI and the lack of awareness of it.

“The court system doesn’t understand and the awareness in general just isn’t out there,” she added.

Carol is now busy working with legislators to amend the existing Alabama law defining second degree assault.

Under the existing law, second degree assault applies to a person who inflicts serious physical injury upon another person with intent to harm. It does not specifically apply to an assault that results in injury to another person’s brain.

According to the proposed bill SB303, amendment 621 would expand the term “serious physical injury” to include the brain specifically. “The bill would provide that a person commits the crime of assault in the second degree if the person, with intent to cause any physical injury … causes serious physical injury to the brain of another person.”

Moreover, the bill would add language to the existing law that would define brain injury for legal purposes: “Serious physical injury to the brain means impairment of a person’s brain which creates a substantial risk of death or protracted impairment of the function of the brain.”

Types of TBI resulting from an assault will include “extreme rotational cranial acceleration and deceleration and one or more of the following: Subdural hemorrhaging, intercranial hemorrhaging, or retinal hemorrhaging.”

Carol remains hopeful as the bill makes its way through the legislature. “If this bill passes all the way, then I will be working on amending the penalty law, calling for a stiffer penalty for people who commit an assault that results in traumatic brain injury,” she said. Carol believes that because TBI can have such devastating effects on one’s life, that causing one should carry harsher penalties.

“We need to increase accountability. Juvenile laws are being taking advantage of,” Carol explained.

“Laws don’t just materialize out of nothing. They’re formed because people and circumstances demonstrate the need for them,” she said.

Part of Carol’s frustration arises from the feeling that she and her son are left behind to struggle while Jason’s assailants carry on with their lives. She believes the implications of TBI permeate just about every aspect of life for victims and their families.

Shortly after doctors finally discovered the severity of Jason’s brain injury and admitted him to the neurology ward, Carol’s daughter was giving birth to her granddaughter at another hospital. “Most people do not have both of their children in the hospital at the same time for two different reasons,” she said, explaining that what should have been a time of pure joy was complicated by the stress and devastation she was experiencing with Jason in the hospital.

“I was pulled by different emotions at the same time. Happy for my daughter and grandchild, but sad and worried for my son, hoping he survived and dealing with the crime in general. Only by the grace of God did I survive,” she said.

More recently, Jason began experiencing sleeping disorders resulting from his TBI. Jason’s doctor at the University of Alabama Birmingham’s Traumatic Brain Injury Center recommended that Jason start taking prescription medication for the sleeping problems. However, when Carol contacted her health insurance company, she was told that it would not cover “any sleep disorder problems.”

“This is so unfair to crime victims because they end up with no choice in the matter. A lifetime of health problems caused by the assault,” Carol said, adding that the crime’s aftermath continues to manifest in unexpected ways long after the fact.

“This is just another example of crime victims being victimized again and again,” she said.

SOURCE: Personal Injury Attorneys › traumatic brain injury: Jason’s story part four

However difficult, Carol’s mission for justice uncovered a valuable legal tool called a “victim’s impact statement.” The statement, which can be either written or oral, allows victims of crime and their families to participate in the criminal justice system by articulating the pain, anguish, and financial hardship resulting from the crime. The victim’s impact statement provides the court with critical information, which helps the judge determine the appropriate sentences and restitution.

Carol prepared a victim’s impact statement, communicating how the crime affected her family. Jason also wrote a statement describing the assault and its impact on him from his point of view. By expressing their own stories, Carol and Jason added a personal dimension to the crime, taking it from an abstract event to something devastatingly real.

“I found that the victim’s impact statement played a big, big portion of how the turnout was for this kid (the accused),” Carol said.

“Because of the impact statement, the probation officer recommended more happen besides straight probation, which is basically what the Juvenile Justice Act is,” Carol said, adding that the DA finally stood up for her and echoed the probation officer’s recommendations.

“The judge sentenced the kid to 60 days in jail and 3 years probation. I found out that 3 years is the maximum probation he could do. Also, the 60-day incarceration was practically unheard of in juvenile cases.”

Carol said that Miriam Shehane, the founder of Victims of Crime and Leniency (VOCAL) attended some of the hearings. “She has done a lot for crime victims by taking her tragedy and turning it around as an advocate. I feel now that I’ve been through enough to share my own story and get in front of the legislature and speak on behalf of other crime victims and their families. It’s important to let people know what crime victims go through in dealing with the criminal justice system,” Carol said.

Now Carol also has joined the ranks of those advocating for the rights of victims. She has spoken with Alabama Attorney General Troy King about the rights of victims and has joined the Crime Victims’ Task Force, which seeks ways to make the Crime Victims’ Bill of Rights enforceable and to toughen current legislation for offenders.

The Crime Victims’ Bill of Rights helps victims of crime navigate through the bureaucratic and often confusing court system.

“Many victims complain about not being notified or informed about the progress of a case or what they can do to help their case, like the victim’s impact statement. In most cases, no one tells you what you can do. Nobody sits down with you and goes over the crime victim’s bill of rights. You don’t know what to expect – what the steps and stages are,” Carol explained.

“For instance, many victims miss the final sentencing because they aren’t aware that it is the final chance they have to speak out and tell their story; to make their statement,” Carol said.

Carol is currently working with the Attorney General’s office to make the bill of rights enforceable, so that “victims will have recourse if they find their rights were violated or if they were not properly informed,” Carol said.

“Right now, there is nothing in Alabama law that if a victim’s rights are violated that they can do anything about it. That’s what this task force is about – somehow making these rights enforceable. By developing a consequence for NOT properly informing victims, hopefully this will make the system work the way it ought to and help put in place a working system for keeping victims informed and involved in the process,” Carol said.

“And then, if you go through the system a second time, it’s the same. You think it will be different the second time. You think it will be better, but it’s the same thing. You are violated by this system all over again,” she said.

“Under the current system, victims and their advocates are normally overwhelmed with other tasks, and nobody in the court system is dedicated to this part of the legal process,” Carol explained. “The victim falls through the cracks.”

Next: Jason’s Story Part 4 – Changing minds and changing laws

Other sources:
http://www.ago.state.al.us/documents/victims_rights.pdf
http://www.vocalonline.org/index.php?option=com_content&view=article&id=49&Itemid=55
http://www.ago.state.al.us/victim_links.cfm

SOURCE: Personal Injury Attorneys › traumatic brain injury: Jason’s story part three

As senseless and horrible as Jason’s experience is, it is far from unusual. According to the National Institutes of Health, approximately 20 percent of the 1.5 million annual cases of TBI in the United States is caused by acts of violence. That is to say that every year, 300,000 people sustain permanent, life-altering TBI. Like Jason, these people are victims of a physical assault of some form.

Once doctors discovered Jason’s TBI and set him on an appropriate course of treatment, his mother Carol could turn more of her attention toward the actual crime. She immediately realized, however, that the mission would not be an easy one. “Jason, like many other crime victims who are knocked unconscious, could only remember bits and pieces of what happened,” Carol explained. She turned to the Auburn Police Department, hoping they would be able to tell her the specific details and circumstances of the crime. To her frustration, Carol found that although a report had been filed in Auburn, the reporting officer would not return her calls.

“I was so distraught that I didn’t know anything about what had happened to [Jason],” Carol said. Eventually, a detective from the police department heard about Carol’s quest to find out what happened to her son and sympathized. “He actually got personally involved and became a friend and advocate for us,” she said.

“Most victims’ families don’t work with the detective. But the path you go down is absolutely horrifying,” Carol said, adding that the trauma of the crime was compounded by the stress of trying to find out who assaulted her son and why.

The three men who allegedly assaulted Jason were brought before a Grand Jury in Lee County, Alabama. According to Carol, the District Attorney’s office told her that she could call in a couple of weeks to check on the status of the rulings. She called as instructed, but her inquiry was angrily dismissed, leaving her no way of checking on the proceedings. Months later, in January, Carol called the Lee County Sheriff’s Department to find whether any arrest warrants had been issued for Jason’s alleged assaulters.

“That’s how I found out there was an indictment,” Carol said. “The kid had already been bonded out, gotten an attorney, and was scheduled for pre-trial. The DA’s office never notified me.”

Carol’s experience with the DA made her feel that people who commit crimes enjoy more rights and protections than victims of crimes and their families. “That’s where I got involved on the crime victim’s task force,” Carol said, explaining that victims and their families should be treated fairly and notified by authorities of legal proceedings involved in their case.

Two of the men who were accused of attacking Jason were indicted for 2nd degree assault, but they were protected as juveniles under Alabama law. Because they were both under 21 and had no prior police record, they automatically received youthful offender status for the felony.

Carol contacted the District Attorney to tell him that she was unhappy with the ruling. “After my son was knocked unconscious one particular kid continued to beat and kick my son in the face,” she said.

According to Carol, the judge granted youthful offender status without reading the case file. After complaining to the DA and making several phone calls, Carol learned that the DA could file a motion for a hearing on her and her son’s behalf. She wanted the judge to hear her side of the story and hopefully change his mind about the youthful offender status. After placing the right amount of pressure on the DA, a motion was filed and a hearing was scheduled.

Carol explained that her hearing is “where I learned the judge and the DA’s office thought I was blowing this out of proportion.”

“They did not understand the long-term possibilities of traumatic brain injury,” Carol said. “The judge said he wished he’d known all this before he made his original decision,” she said.

Next: Jason’s Story, Part 3 – the Crime Victims Bill of Rights

SOURCE: Personal Injury Attorneys › traumatic brain injury: Jason’s story part two

The three men who assaulted Jason caused him to fall backward and hit his head on the concrete pavement, knocking him unconscious. Aside from several contusions on his head, Jason experienced tinnitus (a constant ringing in the ears), difficulty hearing, and vertigo. Emergency medical personnel transported Jason to East Alabama Medical Center in Opelika, where physicians assured Carol that Jason had just received some cuts on his head and would be fine.

“The sad thing about traumatic brain injury is that you can look normal,” Carol said. Jason appeared to be relatively intact, so doctors sent him home.

According to Carol, the next 24 hours turned out to be “very upsetting.”

Jason woke up vomiting blood. Carol helped him into the car and drove him to the emergency room at Baptist East Hospital in Montgomery. Upon arriving, Carol attempted unsuccessfully to get hospital staff to bring a wheelchair out to the car as Jason was unable to walk. Having obtained a wheelchair inside the ER, Carol went back to the car and put Jason in the chair herself and wheeled him in.

Inside the hospital, Jason felt increasingly dizzy and threw up every time he moved, yet he was not permitted to lie down. Carol even had to leave her son unattended in the hospital while she went back out to move her car.

Hours later, doctors discovered the severity of Jason’s injury. Besides the open wound requiring three metal staples, Jason suffered from fractures on his skull and jaw. Both fractures transected and severed the nerves in his right ear, leaving Jason deaf on that side.

Jason was transferred to the intensive care unit at Jackson Hospital, where he remained for 24 hours. He then spent 5 days under observation in the hospital’s neurology ward. The same day he was released from Jackson Hospital, he went to an oral surgeon who operated on his jaw and wired his mouth shut.

All of Jason’s doctors focused on the visible injuries – the ones that could be seen with the naked eye or by x-ray and treated accordingly. The invisible injuries, however, remained undetected and untreated.

Several weeks had passed and Jason called his mother to tell her that there was something wrong with him. “He felt very depressed, and that wasn’t like him. He knew there was something wrong,” Carol said.

Worried, Carol called Jason’s neurosurgeon and told him about her son’s concerns. The doctor put her in contact with a neuropsychologist who was familiar with TBI. Only then did the deeper significance of Jason’s injuries come to light.

“Nobody had ever told us this at all, about traumatic brain injury. Had my son not called me, I don’t know that we’d have ever found this out. He had anger, he had PTSD, he was depressed. We had no idea how all of this was connected. That’s what people really don’t understand about TBI,” Carol said.

“Now I am better able to help Jason understand that this is part of his TBI, so he isn’t as scared or confused about why he is reacting the way he is.”

According to the Brain Injury Association of America, as many as 1.4 million people sustain TBI every year in the United States. Of those, approximately 50,000 die, 235,000 are hospitalized, and more than one million are treated and released from an emergency department.

Jason’s ordeal underscores the confusion and anxiety that many head injury victims and their families experience given the elusive nature of TBI.

Because TBI is so common yet so poorly recognized, Carol believes it is critical to raise awareness of its causes, its different forms and symptoms, and its treatment. “If parents or loved ones don’t realize, the situation can escalate because they don’t understand that it’s related to a physical injury,” Carol said.

Next: Jason’s Story, Part 2 – Navigating the criminal justice system for victims of TBI

SOURCE: Personal Injury Attorneys › Traumatic brain injury: Jason’s story part one

Most of the troops with TBI received blast-related concussions from being in the proximity of roadside bombs and other explosives. Concussions, as we reported yesterday, are one of the most common causes of TBI, affecting as many as 3.8 million people in the Unites States. While concussions represent a mild form of brain injury, the symptoms can persist for weeks or months and could worsen if not properly treated.

Telltale signs of concussive brain injury include nausea, dizziness, blurred vision or double vision, sensitivity to light or noise, headache, sluggishness or fatigue, fogginess, confusion, trouble concentrating, and trouble remembering.

More severe brain injuries, such as penetrating head wounds, have longer lasting or permanent damage. Approximately 45,000 to 90,000 troops are afflicted with severe forms of TBI.

According to Lt. Col. Lynne Lowe of the Army Surgeon General’s office, the Army spent $242 million on staff, facilities, and treatment of brain injuries. That amount does not include what was spent by other branches of the armed forces for the treatment of TBI.

Brig. Gen. Loree Sutton, the head of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, told the Associated Press that the work being done to heal troops with TBI will eventually benefit society at large. According to the AP report, “whether the injuries occur while people ride bicycles, play football, skateboard, or ski, ‘we know that this is an issue across the country,’ Sutton said.”

Dr. James Kelly, Director of the National Intrepid Center for brain injuries and psychological health, told the AP that historically it has been difficult bringing attention to the seriousness of brain injuries. “Brain injury was not recognized as a problem … of any consequence and was, especially in the sports community, often dismissed or trivialized,” he told the AP.

“I think that now you’re seeing it being taken very seriously,” Kelly told the AP. “The wartime experience has been a big part of that.”

SOURCE: Personal Injury Attorneys › Returning troops bring attention to traumatic brain injuries

Wakefield filed a claim earlier against the state of Minnesota, which made a $300,000 settlement – the maximum it could be held legally liable. She also sought $1 million from an underinsured motorist claim against Auto Owners Insurance Co., which provided insurance coverage for her employer’s van. But Auto owners offered just $10,000 to settle, so the case went to trial.

The case was tried in the St. Louis County District Court. The jury, comprised of six women and two men, spent 5 ½ hours deliberating before returning a verdict of nearly $3 million in the plaintiff’s favor. The award was one of the largest monetary awards in the city of Duluth’s history.

The 29-year-old plaintiff was driving a van for Glory Shine Janitorial Cleaning when it struck the street sweeper on September 17, 2002. Jurors found that the street sweeping crew’s negligence directly caused the accident.

According to a report in the Duluth News Tribune, “Wakefield was awarded $1,250,000 for future health-care expenses, $675,000 for future pain, disability and emotional distress, $650,000 for future loss of earning capacity, $200,000 for past pain, disability and emotional distress, $158,000 for past health-care expenses and $28,000 for past wage loss. The total award against Auto Owners Insurance Co., a Michigan corporation, is $2,961,000.”

Wakefield’s attorney said that the jury’s decision reflected the seriousness of her client’s injuries, including a mild traumatic brain injury and then emotional and financial hardship the accident has caused.

A Duluth attorney who represented Auto Owners Insurance Co. complimented the jurors even though they didn’t rule on his client’s side. “We had an attentive group of jurors and they worked hard,” Kelly said. “While I disagree with the result they reached, they were the duly selected members of the jury and that’s what they decided.”

SOURCE: Personal Injury Attorneys › Jury awards $3 million to woman injured in sweeping vehicle crash

Traumatic brain injuries (TBIs)

Educating the public about TBIs has become more urgent in Florida, where there has been an upward trend in the number of brain injuries occurring statewide. In 2005, approximately 93,000 TBIs occurred in Florida, resulting in more than 71,000 emergency room visits and 18,000 hospitalizations. 8,200 people suffer from long-term disabilities resulting from TBIs.

Sadly, as WCTV in Tallahassee points out, these numbers do not include Floridians in the armed forces returning from Iraq and Afghanistan. For them, blast-related brain injuries are considered the “signature wound.” Florida is also home to a large number of veterans, making it even more imperative to educate the public.

Domestically, most TBIs occur as a result of falling and striking the head (about 28%), motor vehicle accidents (about 20%), and accidental blows to the head, such as sports injuries, (about 19%).

One speaker, Thom DeLilla, who is the Bureau Chief of the Brain and Spinal Cord Injury Program at the Florida Department of Health, is also a TBI survivor. DeLilla received traumatic brain and spinal cord injuries in a diving accident nearly 40 years ago.

“The general public does not recognize or understand the magnitude of the issue, including the incidence, causes and impact of traumatic brain injury,” he said. “More needs to be done to educate our communities about traumatic brain injuries, how these injuries can be prevented, what actions to take when a head injury occurs, and what programs and services are available to help,” DeLilla said.

Frank L. Toral, president of the Brain Injury Association of Florida and a legal advocate for brain injury survivors and their families, warned that even mild brain injuries can have painful and long-lasting effects on victims and those around them.

“I have personally seen the devastating impact that even mild brain injuries have on a person’s ability to relate to their loved ones, carry on a conversation with family, maintain gainful employment and overall quality of life,” Toral said.

The press conference was sponsored by the Brain and Spinal Cord Injury Program of the Florida Department of Health, the Brain Injury Association of Florida and the WellFlorida Council, a nonprofit organization that raises awareness of health issues throughout the state.

SOURCE: Personal Injury Attorneys › Florida press conference raises awareness of traumatic brain injuries

Many brain injuries occur without direct impact to the head. Combat operations often cause brain injuries in military personnel, as seen in veterans returning from Iraq and Afghanistan. Explosions, for instance, may not actually harm the skull, but they can send a wave of concussive force that passes through and injures the brain. Lightning strikes and severe electrical shocks often cause serious injury to the brain.

The symptoms of a brain injury can range from mild to severe. According to the National Institute for Neurological Disorders and Stroke, a person who experiences a brain injury may experience any of the following symptoms:

• loss of consciousness
• headache
• confusion
• lightheadedness
• dizziness
• blurred vision or tired eyes
• ringing in the ears
• bad taste in the mouth
• fatigue or lethargy
• a change in sleep patterns
• behavioral or mood changes
• trouble with memory, concentration, attention, or thinking

Additionally, more severe TBIs often cause the following symptoms:

• frequent nausea and / or repeated vomiting
• convulsions or seizures
• inability to waken from sleep
• dilation of one or both pupils
• slurred speech
• weakness or numbness in the extremities
• loss of coordination
• increased confusion, restlessness, or agitation

Treatment of TBIs varies depending on the type and extent of injury. Blunt force trauma to the head requires a very different course of treatment than injuries caused by objects that penetrate the skull and brain tissue.

Patients with mild to moderate cases of TBI usually receive x-rays of the head and neck. However, CT scans are normally required for more severe cases. Severely injured patients usually start on a course of rehabilitation that includes customized treatment programs in physical therapy, occupational therapy, speech and language therapy, physical medicine, psychological and psychiatric therapy, and social support.

Other sources:
http://www.pbs.org/wgbh/nova/sciencenow/0306/02.html
http://www.headinjury.com/

SOURCE: Personal Injury Attorneys › traumatic brain injuries greatly varied in cause, type, and symptoms