Over the course of a year, we write hundreds of blogs. In case you missed some, here is a round-up of the most important traumatic brain injury (TBI) stories of the year. (To read any of the blogs, click on the title and you’ll be taken directly to the story.)

U.S. Representative Gabrielle Giffords

The year did not start off well. On January 8, 2011, a man went on a shooting rampage in Tucson, Arizona. Six people were killed, 13 were injured, including U.S. Representative Gabrielle Giffords, who was shot in the head. The rapid response of the medical team saved the lives of a dozen people shot in the rampage, including Giffords’. Over the course of the year, her recovery has been better than anyone could have predicted, a tribute to the medical advances in brain injury treatment.

• Arizona Shooting Spree Aftermath
• Gabrielle Giffords’ Recovery Called Ideal

Long-Term Effect of Concussion

The biggest brain injury story by far is about the long-term effects of concussion, especially in athletes. This year, scientists linked multiple concussions to chronic traumatic encephalopathy (CTE), a kind of central nervous system damage that happens when people suffer repeated head injuries, typically soldiers or athletes in high impact sports, such as football or ice hockey. Early symptoms of CTE include memory problems, difficulty concentrating, and disorientation. As the disease progresses, people with CTE show behavioral problems—poor judgment, aggression, sexual compulsiveness, erratic behavior, and drug and alcohol abuse—as well as increasing nervous system symptoms, including tremors, staggering gait, deafness, and dementia. Unfortunately, the only way to definitely diagnose CTE is to examine the brain of the affected individual during an autopsy. From kids to football players to hockey teams, concussion has been the biggest TBI story of the year.

• Concussion Has Long-Term Effects for Teen Athletes
• Football Player Dave Duerson Donates Brain to Research
• NFL to Diagnose Player Concussions on the Sidelines
• Will NHL Take Action Against Concussion?
• Athletes’ Dementia: New Name for an Old Disease
• What You Need to Know About Youth Sports Concussion
• Football Players Sue League Over Concussion Risks
• Football Players Demand Better Health Monitoring
• Repeated Head Trauma Can Lead to CTE
• Kids Suffer Long-Term Effects from Head Trauma

Cheer Safety

What do you call an activity requires strength, stamina, flexibility, agility, planning, and coordination with team members?  What if the participants were required to train with weight-training and aerobic exercises?  And what if that activity was performed in gymnasiums, in stadiums, and on outdoor fields?  And what if teams competed regionally and nationally? Sounds like a sport, right? Well, not to sports authorities. Cheer (what used to be called “cheerleading”) injures participants like a sport, including some devastating head injuries. That’s why we wrote a 3-part series on cheer as a sport.

• Cheerleaders Are Athletes, Part One
• Cheerleaders Are Athletes, Part Two
• Cheerleaders Are Athletes, Part Three

How to Hire an Experienced Brain Injury Lawyer

TBI is a difficult, complex injury for doctors to treat…and for lawyers to pursue. If you are considering pursuing a legal case, it’s important to choose an attorney who knows the complicated ins and outs of brain injury. That’s why we’ve provided this guide:

• How to Hire an Experienced Brain Injury Lawyer

VIDEOS

In addition to blogs, we also create videos about important health, medical, and legal topics. To see all of our available videos, please visit our YouTube channel here:  HensonFuerst YouTube Channel

Here are links to some of our brain injury videos:

Symptoms of Concussion

Epidemic of Concussion in Youth Sports

Hiring an Experienced Brain Injury Lawyer

When children suffer a head injury, parents are always relieved once the tears stop. But a study published in the November 2011 issue of the journal Pediatrics reveals that children with moderate or severe traumatic brain injury (TBI) have substantial long-term reduction in quality of life.

The study examined 729 children treated for TBI. Researchers tested the children 3, 12, and 24 months after their injury for their health-related quality of life, their participation in social and community activities, and their communication skills and ability to care for themselves.

The findings were surprising:  Quality of life was lower at all follow-up times. Social activities were significantly affected even after 3 months, but were improved (although not back to pre-injury levels) after a year or two. Communication and self-care abilities were lower at 3 months, and did not improve by 24 months.

The lesson:  A bump on the head can have effects that last much longer than the tears. Prevention of head trauma is key. But if injury occurs, get prompt medical attention to ensure that a serious injury doesn’t become a devastating problem.

RESOURCES

To read an abstract of the Pediatrics article, click here:  Pediatrics

To learn more about TBI, visit our dedicated web page here:  HensonFuerst Brain Injury Page

When most people think of service dogs, they think of a Labrador Retriever or German Shepherd helping a blind person navigate the world. That’s why Chloe is so unexpected.

Chloe is a 17-pound mutt (best guess is that she is a mix of Bichon Frise, Poodle, and Shih Tzu) that was living in an animal shelter, scheduled to be killed. Instead, she found a second life as a service dog for Marine Dan Sauer. The big Marine and the teensy dog make an unlikely pair. But they help each other.

According to an article in the Daily Herald, Sauer was in the service for eight years, including nearly 10 months in Kuwait during Desert Storm. He was diagnosed with post-traumatic stress disorder 13 years ago.

During the war, Sauer suffered a traumatic brain injury from a mortar round that also tore the retina in his left eye, damaged a fingernail on his left hand and affected his memory. Sauer’s experience overseas and PTSD made him bunker down at home and avoid people. For years, he didn’t seek treatment for PTSD.

“I’m a Marine,” Sauer said, describing his mentality before he finally got help. “Just deal with it; that’s all.”

Chloe helps by sensing when Sauer is aggravated, angry or stressed, and then to distract him from those feelings. She also senses when he is having nightmares and wakes him up at night…cuddles close to help de-stress him…and protects Sauer’s personal space by standing between him and other people. It sounds simple, but the effects are dramatic. In the time that he has had Chloe, Sauer is able to leave the house and live a relatively normal life.

He’ll run errands, go for walks and participate in and attend school functions, all with the dog in tow. He’s also a lot more social and cracking more jokes.

But one problem keeps popping up:  Many people don’t understand Chloe’s job as a service dog. Shop owners will tell him that he is not allowed to bring his pet in the shop, and restaurants try to refuse to seat him. But service dogs are allowed by law to accompany their disabled owner nearly everywhere. Sauer takes every opportunity to educate people about the valuable role service dogs can play in rehabilitating brain-injured war vets.

It’s a great relationship for everyone—for Sauer, for Chloe, for Sauer’s family, for Sauer’s community. And it’s a great lesson for the rest of us that sometimes disabilities are invisible…and sometimes even the smallest creatures can help change the course of a life.

To read the full story in the Daily Herald, click here:  Tiny service dog heals Hampshire Marine

We know that getting hard hits to the head can cause concussion and brain injury. That’s why we worry so much about football players, boxers, and soldiers, who regularly get their heads smacked around. But a new study reveals that soccer players may also be at risk.

The study, which was discussed at the annual meeting of the Radiological Society of North America, found that regularly heading a soccer ball (bouncing the ball off the head) can lead to concussion-like brain injuries. According to MSN Fox Sports, the researchers scanned the brains of 38 amateur soccer players, and compared the images to the number of times they deeded the ball during the past year. Players who exceeded 1000 headers per year had “significant injury” to the brain. The damage was done to five specific areas of the brain, areas responsible for attention, memory, and vision. Functionally, players who frequently headed the ball performed worse on tests of verbal memory and hand-eye coordination.

“Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain,” [lead author Michael Lipton] added. “But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells.”

The damage caused by soccer balls is insidious—it sneaks up on players after months or even years of normal play. This is different from the more slam-bam kinds of immediate concussion damage done in the more hard-hitting sports. But in some ways, that may make soccer more hazardous because you can’t prevent the damage without totally changing the rules of the game. This was just a small study, so it is too early make specific recommendation. Experts suggest that players try to minimize heading, especially during practice.

According to Canadian television station CTV, brain injury specialists with the non-profit group ThinkFirst identified heading as a possible safety issue three years ago, and drew up guidelines on how to headhit the ball safely. Their number one rule was not to teach the skill too early to children.

“So anybody out there who’s listening to this who has a child less than 10, do not teach that child to head the ball. Then if they are of the appropriate age, which is 10 to 12, then they can start learning how to head the ball with the appropriate sized ball,” ThinkFirst founder Dr. Charles Tator tells CTV News.

So the general advice seems to be to delay teaching heading until a child is at least age 10, and to minimize the amount of heading done in practices. For individual soccer players, I’d recommend just using your noggin, but that would just be a horrible pun, so I’ll just say to protect your brain and minimize the use of heading.

RESOURCES

To read the full story on MSN Fox Sports, click here:  Heading soccer ball may lead to brain damage

To read the full article on CTV, click here: ‘Heading’ a soccer ball could cause brain injury

A new product is the latest tool to  combat sports concussions. The Impact Indicator (by manufacturer Battle) is a chin strap that connects to a player’s helmet.  It measures the force and duration of a hit to the head: When first connected, the impact indicator LED light on the chin is green…but after a hard hit, the indicator turns red. This can be a signal of a potential head injury, so that coaches and players can act appropriately.

The device, which costs about $200, is endorsed by former hockey star Keith Primeau. It is currently being worn by more than a thousand youth football players in the United States, and it can also be used by hockey and lacrosse players.

Primeau, now age 39, played in the NHL for 16 years before his fourth documented concussion forced him to retire from the Philadelphia Flyers. He still feels crippling effects of his head injuries: headaches, head pressure, dizziness and fatigue.

According to an article in The Globe and Mail:

Primeau said the Impact Indicator doesn’t prevent concussions but indicates when someone should come out of a game. Information is a weapon in the fight against concussions, he said. People can have an objective measurement rather than just subjective judgment of coaches, teachers, administrators and even physicians on the sidelines.

Once the LED turns red, there is a 50% probability of a concussion. At that point, a player shouldn’t take anymore head hits. It takes the guesswork out the equation:  When the light turns red, the player should be removed from play and see a doctor.

Whether players, coaches, and team owners will ever fully adopt the new technology remains to be seen, but it seems like a no-brainer. We support measures that help preserve health and prevent brain injury. Paralympian Paul Rosen won a gold medal with Canada’s sledge hockey team. He believes that losing his leg in 1999 was easy compared with post-concussion symptoms. As he told TSN:

“Losing my leg was an absolute joke in the way I dealt with it compared to what I’m dealing with on a day to day basis,” said Rosen, who suffered a concussion after a sled hit him in the head. “Thing was, they told me to suck it up. We have to get out of this mentality, whether kids are 10 years old or playing professional hockey, is get out of that mentality of suck it up.

“One hit to the head is one hit too many.”

To read the full article in The Globe and Mail, click here:  New chin strap flashes red

To read the full article on TSN, click here:  Primeau believes helmet can cut down on concussions

Researchers from the Mayo Clinic and UCLA have discovered that people who suffer from traumatic brain injury (TBI) are four times more likely to develop Parkinson’s disease than people who have never had a head injury.

According to an article on Digital Journal, the researchers reviewed the past medical records of about 200 patients, looking to see if those who had experienced head trauma at some time in their lives later developed Parkinson’s disease. Why might this be true? The answer comes from another research study:

The UCLA team found that brain trauma causes an immediate 15% loss in brain cells called nigrostriatal dopaminergic neurons. The loss of these cells continued so that after about 6 months, up to 30% of those neurons were lost. It is the loss of these dopaminergic neurons that make a person more susceptible to Parkinson’s disease.

Although there is still no cure for Parkinson’s disease, this research may provide another piece of the puzzle that could eventually lead to prevention or more effective treatments. But in the meantime, the sad news is that people who suffer TBI need to be watchful for signs of Parkinson’s disease as they grow older.

The post-game video review was especially difficult at John C. Birdlebough High School. Administrators and coaches examined every frame of what will forever be known as “THE game.” The game when 16-year-old Ridge Barden died.

According to an article in The New York Times, the coroner ruled that Barden’s death was due to a brain bleed, also known as a subdural hematoma. But while the reason for his death is known, the actual cause is still a mystery.

“There’s nothing here; there’s still nothing there; there’s nothing there; there’s nothing there — and now he’s laying on his stomach,” Jeff Charles, the head coach, said while watching the sequence frame by frame.

Apparently, Barden had no preexisting condition, no history of head trauma, and no symptoms of concussion during the game. He had a state-of-the-art Riddell Revolution helmet. On hand at the game were two certified athletic trainers, and emergency medical technicians arrived with an ambulance within minutes. And yet, a catastrophic injury resulted in an untimely death.

“You can have the perfect plan in place but if all of these things happen, it can still result in a catastrophic injury and death,” said Kevin Guskiewicz, the chairman of the department of exercise and sports science at the University of North Carolina and a leading researcher on sports concussions.

During the game, Barden told his coach that he had a helmet-to-helmet hit, and that his head hurt. When he tried to stand up, he collapsed. He went into cardiac arrest in the ambulance. Two hours after the injury, he had died.

This is a tragic story all around. The coach is considering not returning for another season, despite the fact that everyone agrees he did nothing wrong. No doubt, his teammates—and their parents—will also be reconsidering whether to continue playing football.

The lesson seems to be that any head injury is dangerous, and you can’t predict the outcome of any one hit. Barden never had a chance to say “Yeah, I already had one concussions…I think that’s enough. Time to quit.” His first hit was his final hit. The fatal hit.

All we can say is stay safe. Protect your head. Barden’s death was a fluke. Nothing could have been done differently or better. Sometimes, life is dangerous.

To read the full article in The New York Times, click here:  An ordinary football game

To learn more about legal options in the event of a traumatic brain injury, visit our website at www.lawmed.com.  If you have questions, HensonFuerst has answers.

According to an article in Bike World News, two major cycling organizations have jointly released recommendations for how to treat cyclists who have sustained head trauma.

Medicine of Cycling, an independent group of physicians and psychologists working to improve processes that can have a meaningful impact on the way care is delivered to cycling athletes, recently formed the Medicine of Cycling Concussion Task Force which aims to increase awareness of concussion and improve safety for cycling athletes. The guidelines pertain to adult athletes only, as younger riders are even more vulnerable to brain injury. These guidelines are intended to educate cycling team managers, coaches and athletes on the symptoms and management of concussion in athletes. The guidelines are not a surrogate for evaluations by appropriately trained medical professionals.

The guidelines include actions to take in the pre-season, how to evaluate for concussion after a head injury, and considerations for returning to cycling after a concussion.

If you are a serious cyclist—especially if you are a member of a cycling team—you need to read these concussion guidelines so that you, team coaches, and teammates are all on the same page when it comes to head injury.

Ride like the wind… but stay safe!

P.S.  If you would like to join the HensonFuerst Cycling Team, we are adding new riders to our group. We ride for fun, and for community support, fundraising for health organizations, and disease awareness. Cyclists of all skill levels are welcome.

RESOURCES

To read the full article in Bike World News, click here:  Medicine of Cycling releases concussion guidelines

To read the concussion guidelines, click here:  Concussions in Cyclists

Can motherhood cause brain injury?   Yes… indirectly.

An article in the Deseret News recounts the experience of mom Erin Stewart, whose preschooler gave her a concussion:

Motherhood is rough. I’m not talking about emotions here. I’m talking physically rough. I’m talking just-got-back-from-the-doctor-with-a-minor-concussion rough. Seriously. My preschooler gave me a concussion.

In what will forever be known in our family as the day mom officially became a wimp, my 4-year-old daughter slammed her head into the back of mine. She was fine; I screamed in pain. A week of headaches later, I went to the doctor (despite my husband’s mockery) and was told I likely have a concussion.

This article is humorously written, but also educational. Concussions don’t just happen to football or hockey players, skateboarders, or daredevils. Concussions also happen to moms… or grandpas… or anyone who has a brain. All it takes is a blow to the head, even if the blow is delivered by a little girl.

Where Erin was mistaken—and where the article fails—was when she waited a week to seek treatment for her constant headaches. (All the worse if she really delayed her visit to the doctor for fear of more mockery from her husband.)

A concussion is also known as mild traumatic brain injury (MTBI). While the symptoms are often mild and temporary, some concussions are serious. Depending on the exact nature of the injury, the symptoms of concussion can last many long months.  After multiple concussions, some people can develop permanent, debilitating neurologic symptoms that mimic Lou Gehrig’s disease.

So, read this article for the humor Ms. Stewart intends, but keep in mind it’s lesson, also:  Concussions can happen to anyone, and often occur when we least expect it. And sometimes they are caused by cute little girls.

At about 2:00 pm, second grade student Michael Rodriguez slipped on some water at school and hit his head. By 6:00 pm, his mom was rushing him to the hospital. The basic story is simple, but the lessons are in the details.

According to a Texas-based news source, VictoriaAdvocate.com, by the time 7-year-old Michael got proper medical care, he was screaming “My brain hurts…I’m going to throw up.” After a CT scan, he was diagnosed with a skull fracture and contusion.

Michael’s mom, Michelle Robinson, who also has three other children reported that she had had previous difficulty communicating with the school nurse about her kids’ medical problems. According to VictoriaAdvocate.com:

“I personally went to the office and told her, ‘I don’t care if it’s something as little as a cut on his knee, I want to know,’” Robinson said. “At that time, she pulled all my kids’ emergency medical cards and wrote on there in red pen, ‘Call mom for anything.’ She led me to believe that communication was going to be better.”

Robinson did not receive a phone call about her son’s afternoon head bump.

The issues raised involved the nurse’s qualifications (the school said that the nurse was certified as a “licensed vocational nurse” who was in her first year with the school); the nurse’s treatment of Michael (the nurse’s clinic notes indicate he was treated for about a minute, and the child was sent back to class with just an ice pack); and protocol for head injury (standard protocol involves monitoring a student for 20 minutes to watch for symptoms of slurred speech, blurred vision, headache, etc.).

“What if it happens again? What if it happens to another child, and it’s worse next time? I will be more than happy to use my son as an example and do something to reprimand this nurse, or it can happen again,” Robinson said.

It is frightening to think how easily a slip can change from a “bump” to a skull fracture.

While there is no way to prevent all accidents, there are some tips provided by Dr. Jeffrey Lehman, Director of the Huff & Puff Allergy and Asthma program at St. John’s Children’s Hospital (on FoxIllinois.com) about how to ensure that your child receives the best care possible in school:

• If your child needs specialized treatment, make sure the school’s staff knows how to administer medications and other treatments;
• For chronic medical problems, provide the school with a personalized management plan to take the place of the school’s standard plan;
• Give the school a recent photo of your child to include in the child’s medical file, as well as up-to-the minute contact information for you and any other emergency contacts.
• Ask about the school’s protocol for dealing with common injuries, including falls and head bumps. Make sure you understand exactly what will happen if your child is injured.
• And even though it didn’t work for Michael’s mom, ask to have the school contact you anytime your child visits the school nurse.

To read the full story on VictoriaAdvocate.com, click here:   7-year-old Suffers Skull Fracture