The rapid response of the Tucson, Arizona medical team saved the lives of a dozen people shot in a gunman’s rampage. Among the injured was U.S. Representative Gabrielle Giffords, who had been shot in the head. This week, neurologist Richard C. Senelick, M.D., gives us a peek into the challenges Representative Giffords will face as she recovers from such a severe brain injury (“What Will Gabrielle Giffords’ Recovery Look Like“).

According to the article, the bullet traveled through the left side of Rep. Giffords’ brain. But, her doctors also pointed out that:

…the damage is not done just by the bullet passing through the brain but also by the shock wave or “cavitation effect” that damages the brain tissue around the bullet track.

People with brain injuries can face numerous disabilities, some quite unexpected. There are three categories of potential problems:

1. Physical Impairments, including seizures, paralysis, loss of feeling, problems with speech or swallowing, and fatigue.
2. Cognitive Disturbances, or problems with thinking. These include difficulty with memory, attention, concentration, planning, judgment, learning new things, and communication.
3. Behavioral Disturbances, or personality changes. Common behavioral issues include irritability, depression, verbal or physical outbursts. Perhaps the most difficult to deal with is something called “inappropriate behavior,” which is like losing your social censor—the person does or says whatever comes to mind, without any thought of consequences.

This brief overview is just a slice of what Rep. Giffords will face. Her recovery will be long and unpredictable. After she leaves the acute care hospital, she’ll be transferred to a rehabilitation facility where she will learn to take back her life. As Dr. Senelick says:

… [it is] difficult to predict Representative Giffords’ future…. I am frequently gratified by the impressive recoveries that many patients make after extensive rehabilitation efforts.

Like the rest of the world, all of us at HensonFuerst Attorneys send our best wishes to all the Arizona shooting victims and their families, and condolences to the families of those who died. It was a senseless act that stunned the rational world. There are no words… only prayers.

To read the full article, click here: What Will Gabrielle Giffords’ Recovery Look Like, by Richard C. Senelick, M.D.

I just read a fantastic editorial about head injury and concussion in youth sports, written by someone who knows and cares: Neurologist Richard C. Senelick, M.D., Medical Director of the Rehabilitation Institute of San Antonio. He is also a father and a grandfather, so this topic is more than just an abstract medical exercise to him.

We have written extensively about the dangers of concussion–what doctors now refer to as “mild traumatic brain injury” or MTBI. So far, this has been a watershed year in how concussions are viewed. This year, we learned that a person who receives multiple concussions is at risk for developing Chronic Traumatic Encephalopathy (CTE), which leads to early dementia, depression, personality changes, and death.

We also learned this year that some cases of amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s Disease) may be due to head trauma, not disease process.

This is also the year that we found out that the number of head injuries in children’s sports have doubled or even quadrupled in the past 10 years. MTBI awareness has even reached that most hard-headed group, the National Football League, which has mandated that an educational poster about concussion be hung in every pro locker room.

As Dr. Senelick states:

Although the population of NFL players is important, there are only 1,900 active NFL players each season. There are more than 3 million children playing football at the youth level and 1.2 million more playing high school football. This doesn’t even begin to count the number of kids playing soccer (heading the ball) and hockey (body checking). We have to ask whether we are taking adequate steps to protect our children – to change not just the equipment but the rules so that we reduce the chances of the players experiencing traumatic brain injuries.

What does he suggest? The same things experts and investigators have been suggesting for years:

1. Change the rules of the games to make head injury less likely.
2. Change the equipment, helmets and the equipment that makes dangerous projectiles of balls and pucks.
3. Mandate certified trainers in schools and for all organized sports activities.
4. Change the culture, so that we value health over winning a game…especially when our children are young, their brains are developing, and the games will be forgotten by morning.

None of that will be easy. Think how difficult it is just to get people to use a seat belt in a car, or to wear a helmet while cycling. Dr. Senelick notes that in Idaho…

We have an increasing number of bear attacks because people foolishly approach a bear, thinking it is safe to get that close-up picture. I recently read the following analogy:  If people are in the ocean and hear someone yell “shark” they race out of the water. If someone yells “bear” in Yellowstone, everyone races to get a close-up photograph. They have not been properly educated on the dangers of close encounters with a bear.

The same is true for youth sports and brain injuries. There is a bear out there and people need to be educated and the rules need to be changed.

He ends his editorial with this sentence:  ”Our children are getting injured and dying — it is time to wake up.”  Given the traumatic head injuries we have seen, we agree.  The only thing more heartbreaking than seeing a child with a head injury is watching the agony of that child’s parents. No one gets over it…not the child, not the parents, not the grandparents, not the community. We owe it to…well, everyone to help protect our children from head injury.

If you want to learn more about concussion and other traumatic brain injuries, visit our website at www.lawmed.com. If you have questions, HensonFuerst has answers.

Our previous blogs on concussion:

Football Concussion Poster

Youth Concussion Rates Skyrocket

Metal Bat Controversy in Youth Baseball

Head Injury and Lou Gehrig’s Disease

To read Dr. Senelick’s full article, click here: Head Games and Youth Sports: Have We Gone Too Far?

To read a great Time magazine article, which has a link to a video of what football can do to the brain, click here:  The problem with football:  How to make it safer

Studies consistently show that over half of brain injured persons suffer from chronic depression. Cognitive and physical deficits are common results of brain injury, and those deficits cause loss of self-esteem, inability to enjoy life, and inability to effectively relate to others. Depression also impacts the individual’s ability to recover from the brain injury, or to effectively manage their lives even after they have recovered from the physical limitations imposed by a TBI. Please be aware that the depressive symptoms can warrant treatment as well, and the fact that such symptoms are intertwined with the physiological aspects of the brain injury demand that a neuro-psychiatrist or similar physician trained in TBI issues will be critical to recovery. For a more detailed article on TBI and depression, follow this link:  

http://www.biausa.org/elements/BIAM/2004/depression.pdf