Traumatic Brain Injury Blog

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Tagged with “Head trauma rehabilitation”

November 6, 2017

The Challenges of Concussion Diagnosis, Prognosis and Treatment: The Most Complicated Disease of the Most Complex Organ of the Body

A review published in the September 2017 issue of Frontiers in Neurology proposes use of “systems science” to better understand concussion diagnosis and prognosis.  This is a discipline that analyzes complex problems as whole systems and integrates research findings from different disciplines. In explaining the need for a systems approach, the reviewers note one description of concussion that is uniformly recognized – that it is a highly heterogeneous phenomenon, with numerous factors interacting dynamically to influence an individual’s recovery trajectory. (This concept is highlighted in the title of one of the Concussion WebCasts made available by the American Association of Family Physicians : “If you have seen one concussion, you have seen one concussion.”) Read More

January 17, 2017

“Rest Until Symptom Recovery” May Not be the Best Medicine for Children and Adolescents Recovering from Acute Concussion

In a study published in  the Journal of the American Medical Association (JAMA) on December 20, 2016, Canadian researchers found that children and adolescents who returned to exercise within seven days of experiencing a concussion had nearly half the rate of persistent post-concussive symptoms a month later. This finding challenges the current cornerstone of pediatric concussion management, which is physical and cognitive rest until acute symptoms have resolved. Read More

June 17, 2015

A Surprisingly High Percentage of Uncomplicated MTBIs have Persistent Deficits and Require Ongoing Therapy

The April, 2015 issue of The American Surgeon reports on a retrospective study of 395 patients admitted to the ER following concussions (MTBI, or mild traumatic brain injury). The patients had “normal” Glascow Coma scores of 15 and normal CT scans and therefore met discharge criteria. The study found that a surprisingly high percentage of these patients (27%) had persistent deficits after neurocognitive testing and benefitted from referral for ongoing therapy.  The study is authored by Hartwell et. al. and entitled “You Cannot Go Home: Routine Concussion Evaluation is Not Enough.” Read More

October 13, 2014

The Promise of An Effective Drug Treatment for TBI

Researchers at the Henry Ford Neuroscience Institute, a leading neuroscience research facility, recently announced the results of research showing that the only drug currently approved to treat the crippling effects of stroke shows promise, when administered as a nasal spray,  to help heal the effects of less severe forms of traumatic brain injury.  This is exciting news, since researchers have been struggling unsuccessfully for years to find an effective drug treatment for TBI. The research results are based on animal studies, so further work will be needed to determine the best dose and window for administration in humans.  Read More

April 21, 2014

New Data Supports Importance of Cognitive Rest for Concussion Recovery

Most current guidelines recommend “cognitive rest” during the initial stages of recovery from concussion. “Cognitive rest” involves limiting activities that require attention and concentration such as reading, doing homework, text messaging, playing video games, working online, watching movies and television and listening to music.  Cognitive rest has been recommended in the past based on somewhat limited evidence suggesting that failing to minimize these activities in the early stages following a concussion could delay recovery. Read More

March 25, 2014

Visual Dysfunctions following Concussion and other Traumatic Brain Injuries

Recent literature has highlighted the prevalence of dysfunctions in vision following traumatic brain injuries of all levels of severity (including concussion.) Research published by the Veterans Administration (VA) in 2012 indicates that the percentage of TBI victims with vision problems could be as high as 60%.  They explain that this prevalence is not surprising, since over 50% of the brain is involved in visual processing. Alvarez et. al. explain how visual and other symptoms occur when the brain is subjected to  “acceleration/deceleration” forces: Read More

March 3, 2014

The Power of Mindfulness

I travel between two worlds that may appear far apart – by day I am a trial lawyer with a focus on traumatic brain injury; nights and weekends I am a yoga teacher. I increasingly find that these worlds are very close together.

As a brain injury lawyer I work with people struggling to recover from the loss of sense of self so often caused by brain injury as well as associated depression and chronic pain. Many of my clients have reported meaningful increases in the quality of their lives following injury through “mindfulness” practices such as yoga and meditation. Practices such as yoga are designed to increase awareness of the present moment, to increase awareness of our thoughts, emotions and physical sensations without filtering them through past experience or fears of the future – to recapture our sense of ourselves. Read More

February 4, 2014

New Guidance for Patients and Clinicians on Managing Concussion Symptoms

Defense and Veterans Brain Injury Center logoOn January 23, 2014 the Defense and Veterans Brain Injury Center released new clinical recommendations with a standardized approach for concussion recovery.  Included in the recommendations for managing concussion symptoms is a first of its kind five-stage approach for return to activity following a concussion.  Detailed “do”s and “do not”s  are specified for each stage. Movement from stage to stage is determined by scores on a simple twenty-two item “neurobehavioral symptom inventory” included in the recommendations.  Read More

May 15, 2013

Reconciling “ Who I Am Now” with “Who I Used to Be”

The human brain is complex. Every brain injury is unique. But nearly every person who suffers a brain injury experiences that frightening feeling of  “I am not myself anymore.” In mild traumatic brain injury (MTBI) cases, specifically, this feeling may recede over a period of weeks or months. But for others, it does not.

Whether the symptoms are permanent, improve, or get worse, the reasons for these differences are constantly researched—looking for ways to explain, prevent, and/or heal traumatic brain injuries. Several new studies on mild brain injury are examining factors ranging from genetic differences to differences in emotional make-up in order to understand why these differences exist. New research is leading to new approaches in treatment and rehabilitation, as well as prevention.

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