We've maybe been guilty of concentrating too much on Traumatic Brain Injury acquired as a consequence of time spent on the battlefield, yet perhaps, in a perverse way, we should be grateful that these injuries have highlighted a problem within the general population that does not receive the coverage it deserves.

In 2005, traumatic brain injuries suffered in falls accounted for nearly 8,000 deaths and 56,000 hospitalizations of Americans aged 65 and older. As we've discussed before, its not only bones that get broken in these falls, injuries of far greater consequence are not uncommon.

To try to cap the financial outpourings that result from such trauma, the CDC announced an initiative with 26 organizations, including nursing organizations, to help prevent, recognize, and respond to traumatic brain injuries.

Nursing Spectrum

Posted by Dianne Sandland at 08:46 AM | Permalink

There's been a lot of information on this blog recently about how the Defense Department are moving forward with diagnostic research for traumatic brain injury (TBI). What hasn't been mentioned is the latest method of diagnosing TBI, which is, frankly, quite astounding.

The Brain Trauma Foundation, with the support of the Defense Department, is developing a handheld eye-tracking device that will enable military personnel to determine within seconds — on the battlefield — if a soldier has been subjected to traumatic brain injury.

The equipment which is being developed by neurosurgeon Jamshid Ghajar and his team at Weill Cornell Medical College, will be designed to be incorporated into either a pair of goggles or a visor, and will test how well a soldier's eyes track a small, moving red dot.

Clever eh?

USA Today

Posted by Dianne Sandland at 09:07 AM | Permalink

This was the very apt title of a recent conference at the VA center, during which Col. Karl Friedl, director of the U.S. Army Telemedicine and Advanced Technology Research Center explained why brain injuries have become more prevalent.

The main cause of the problem, said Col Friedl, is the improvised explosive device, or IED, a homemade device that, as we have already learned, has become the enemy's signature weapon.

The puzzle surrounding these injuries is that, while some well-armored soldiers were able to survive the IED blasts, incurring no outward signs of damage, they later complained of dizziness and "having their bell rung," symptoms consistent with the lesser-known mild traumatic brain injury (mTBI). The sad fact is that, believing that getting 'knocked about' is part of their job, the soldiers continue in combat, sustaining further injuries. Each of these injuries builds upon the previous trauma, consequently, the effects become increasingly more severe.

The VA center is committed to researching TBI and PTSD, using state of the art neuroimaging techniques to search for clues to treatment.

San Francisco Chronicle

Posted by Dianne Sandland at 10:10 AM | Permalink

The VA are seeking 'scientifically meritorious proposals concerning TBI.'

The Program Announcement comments that, although Kevlar helmets are worn and have undoubtedly saved lives, they do not fully protect against blasts and impacts to the head and face.

The Research Services are interested in the following themes for the research:

* Cognitive dysfunction
* Mood and anxiety disorders, including PTSD, depression, acute distress disorder, etc
* Blast related vision and/or hearing deficits
* Post traumatic epilepsy
* Chronic pain
* Substance abuse
* Suicidality
* Sleep disturbances

The Program Announcement is very detailed, and extremely interesting.

Posted by Dianne Sandland at 09:30 AM | Permalink

The Air Force Times reports that about 4,400 people have received traumatic injury insurance payments since 2005 but, as a result of discussions between the Department of Veterans Affairs and doctors who have been treating severely wounded combat veterans, more than 1,600 severely disabled veterans could receive retroactive insurance payments.

Air Force Times say that payments could be paid as early as this fall and will range between $25,000 and $100,000, with the average payment at $32,000

Officials said the report has 11 recommendations to expand definitions of traumatic injury for insurance purposes, and all are expected to be included in a revised regulation likely to be issued by VA this fall.

No payments can be made until final regulations are issued, but the new definitions would apply both to new injuries and also retroactively to injuries since Oct. 7, 2001.

Air Force Times

Posted by Dianne Sandland at 09:05 AM | Permalink

Mike Wilkinson suffered severe diffuse Traumatic Brain Injury when he was involved in a road traffic collision back in 2005.

The strap line on his blog reads: "Whoever you may be, sometime or other life may well deal you a bad hand. And I can tell you, a severe traumatic brain injury ("TBI") is indeed a bad one! But it seems that the trick to life is recovering well from bad hands. This blog is about the ups and downs I've had and the lessons I've learnt recovering from mine."

Read his entry about TBI Escapism.

There are a number of very recent entries on his blog that sufferers of TBI or others with an interest in the condition will find both interesting and humorous.

Posted by Dianne Sandland at 07:52 AM | Permalink

Over the course of the next year, researchers plan to develop and test an integrated system, which will include a modified battlefield helmet retrofitted with "smart nanotechnology sensors" designed to record the effects of blast injuries in real time. The system will be configured to record and analyze a variety of data on the helmet-wearer’s physical condition, then upload that information to first responders or field-hospital personnel using small cell-phone-like devices.

The research was funded recently through a Concept Award from the U.S. Department of Defense Post-Traumatic Stress Disorder/Traumatic Brain Injury Research Program of the Office of Congressionally Directed Medical Research Programs. Kenneth Watkin from the University of Illinois and joint lead of the project, said

"What we're doing is actually physically monitoring systemic variables of soldiers in the battlefield, embedding our sensors within the helmet. We'll gather baseline data as they’re going about their regular daily business. But once a big pressure wave is recorded, all of the recordings will begin in real time to look at the response in the brain - to look at changes in oxygen in the blood, heart rate, those types of systemic variables that can give us a key that something is happening to the person."

University of Illinois News Bureau

Posted by Dianne Sandland at 09:34 AM | Permalink

Drug NNZ-2566, a synthetic analogue of Glypromate(R), is being developed by Neuren Pharmaceuticals in conjunction with the US Army to reduce neurological, cognitive and psychiatric consequences of traumatic brain injury. The Department of Defense has committed $4 million to fund the trial and early indications are that the FDA will consider this drug for fast track status. The trial is preparing to move onto Phase II.

All rather ironic, given the tone of yesterday's post on this site!

Glypromate(R), another Neuren drug in development, is said to reduce cognitive impairment following cardiac surgery with cardiopulmonary bypass, a condition which affects up to 70% of patients at discharge. Recruitment for Phase III of the trial has been completedl

Neuren's NNZ-2566 and Glypromate(R) have both been deemed worthy of inclusion in the top ten neuroscience projects by Windhover Information Inc, a company that provides analysis of the healthcare industry to decision makers. Windhover are part of the Elsevier group.

IT News

Posted by Dianne Sandland at 08:18 AM | Permalink

Harry Tracy runs Cardiff, California-based NI Re-search, a research consultancy that focuses on the neurological and psychiatric therapeutics industry. Tracy is quoted as saying recently:

The second fastest way to clear a room of venture capitalists and other investors is to announce a bomb threat or yell 'fire,' but the quickest way is to tell them you are a drug developer targeting traumatic brain injury (TBI) or stroke.

To put some perspective on what Tracy was saying, the proportion of mid- to large-size firms developing drugs for brain injuries and illnesses ranges from zero to maybe 5 or 10 percent. The reason for investors shunning the 'brain' market is partially the series of failures in brain injury drugs over the last ten years, specifically those targeted at stroke. More perspective here - 50 drugs for stroke have failed over the last decade.

So, the stroke field is an anathema for investors, and the market for brain injuries suffers because of that. Even the Department of Defense are loathe to put their money where their mouth is - this despite the fact that traumatic brain injury is the second leading cause of death for soldiers serving in Iraq and Afghanistan, second only to hemorrhage. In the population as a whole, more than 1.5 million cases of TBI are reported annually, with at least 300,000 of those hospitalized with severe injuries.

Read more

Posted by Dianne Sandland at 11:44 AM | Permalink

Internationally recognized expert in the understanding of traumatic brain injury, Dr. Ayub Khan Ommaya, has died at home in Pakistan.

The renowned neurosurgeon was a long time resident of Bethesda and a retired chief of neurosurgery at the National Institute of Neurological Disorders and Stroke at George Washington University, where he was also professor of neurosurgery.

Dr Ommaya developed the Ommaya reservoir, a plastic dome-shaped device with a catheter attached to the underside. The device made it possible to deliver chemotherapy to the brain and spinal cord, something which had previously been impossible. Perhaps more noteworthy is the fact that the Ommaya reservoir served as a prototype for all medical ports now in use.

More relevant to this blog was the fact that Dr. Ommaya also developed the centripetal theory of traumatic brain injury. It was this theory that helped scientists to understand and model how brains are affected by blunt force. Serving as chief medical adviser to the National Highway Traffic Safety Administration and director of NHTSA's head injury prevention program, Dr Ommaya created a model for brain injuries that led to design changes and the development of safety devices in motor vehicles worldwide.

Not only was Dr Ommaya a medical force to be reckoned with, he was a trained opera singer and a national swimmer for Pakistan.

Given Dr Ommaya's excellence in the field of neurosurgery and traumatic injury, it seemsrather ironic that his death was due to complications arising from Alzheimer's. Somebody up there has a warped sense of humor.

Washington Post

Posted by Dianne Sandland at 09:46 AM | Permalink

It's a sad fact of life, the older we get, the more likely we are to fall over. There are many reasons for this: diminished sense of balance, reduced reaction time, waning coordination; the secret to avoiding many falls is accepting the increased risks.

Falls are the leading cause of death from injury among the 65 and older age group; in fact, falls cause about 9,500 deaths in the US each year.

And even if a fall doesn't kill you, the consequences are sobering. Mostly, when we think of fall-related injuries, we think of broken bones; however, a recent report in the Journal of Safety Research claims that, in 2005, close to 8,000 deaths and 56,000 spells in hospital were the result of fall-related traumatic brain injuries in people aged 65 and over. That means that traumatic brain injury is a common consequence of falls among senior citizens.

Dr. Joseph Hanna, chairman of the neurology department and director of the Stroke Center at MetroHealth Medical Center says that staying fit and limber may be the best safeguard against falling. He recommends a daily exercise regimen structured around flexibility and balance. Tai chi is an activity that springs readily to mind when thinking about coordination and balance but, in reality, any exercise regime is better than none at all.

To read more of Dr Hanna's recommendations, visit Disability Alert. It just might prevent you, or someone you love, from becoming a statistic.

Posted by Dianne Sandland at 08:48 AM | Permalink

A team of biomedical engineers from Wayne State University in Detroit has been awarded a grant of $1.3 million from the National Institutes for Health. The funds are destined for a new four-year study looking at brain trauma and traumatic brain injuries.

Associate Professor, Liying Zhang, said that, because of limited technologies and data, this is an area of research that has been difficult to follow. Zhang has spent six years researching the mechanics of concussion in National Football League players.

Bringing his expertise to the team is Professor John Cavanaugh, a WSU professor of biomedical engineering, who has actively been involved in extensive research in axonal injury, concussion and spinal disorders.

The research will focus mainly on automobile, sports and blunt trauma that are the causes of most traumatic brain injuries.

The South End

Posted by Dianne Sandland at 12:14 PM | Permalink

Better late than never?

Troops are to undergo neurological screening before deployment from later on this summer. Automated Neuropsychological Assessment Metrics, or ANAM. was developed by the Army more than 20 years ago, and measures things like reaction time and memory.

Taking no more than 20 minutes to administer and considered a big improvement over pen-and-paper questionnaires, one has to ask why it wasn't introduced sooner. However, ANAM could also be seen as a double edged sword; some advocacy groups are worried that the military might abuse the test to deny future benefits to veterans.

New York Times

Posted by Dianne Sandland at 08:29 AM | Permalink

Scientists trying to understand traumatic brain injury from bomb blasts are finding the wound more insidious than they once thought.

They find that even when there are no outward signs of injury from the blast, cells deep within the brain can be altered, their metabolism changed, causing them to die.

This cellular death leads to symptoms that may not surface for months or years. Symptoms can include memory deficit, headaches, vertigo, anxiety and apathy or lethargy

The new findings are the result of blast experiments in recent years on animals, followed by microscopic examination of brain tissue. The findings could mean that the number of brain-injured soldiers and Marines -- many of whom appear unhurt after exposure to a blast -- may be far greater than reported.

USA Today

Posted by Dianne Sandland at 08:00 AM | Permalink

Disability Rights Advocates (DRA) is conducting an investigation of the accessibility of VA hospitals and clinics. They would like to hear from you about your experiences at these facilities.

If you have a mobility disability, a vision disability, a hearing disability, and/or Traumatic Brain Injury, you are entitled to full access and reasonable accommodations, whether or not your disability is service connected. DRA want to know if these accommodations are being provided. Please contact them at va.access@gdblegal.com.

VetVoice

Posted by Dianne Sandland at 09:53 AM | Permalink

The Staten Island Children's Museum, Livingston, will be giving away 100 child-sized helmets on Saturday as part of a safety education program tp be led by Jan Wollney, a Certified Brain Injury Specialist with the Brain Injury Association of New York state.

The giveaway was inspired by a bicycle exhibit at the Staten Island Museum, St. George, and children are being invited to take their bikes to Saturday's event.

Approximately 450,000 children suffer traumatic brain injuries each year and the aim of this program is to teach youngsters and their parents how to avoid these injuries and play safely.

Interactive events are planned, including model brains and gelatin dessert!

Both the helmet giveaway and the brain safety activities are included with the usual $5 museum admission. The program begins at 2:30 p.m. and helmets will be distributed on a first-come, first-served basis.

SILive.com

Posted by Dianne Sandland at 10:02 AM | Permalink