Articles Posted in Current Issues

The lawsuit filed against the NFL by former professional football players has been one of the biggest stories in professional sports over the last several years. Many former players have suffered the repercussions associated with chronic traumatic encephalopathy (“CTE”), and the lawsuit they filed in conjunction with other players suffering various traumatic brain injuries has netted a $1 billion settlement – a settlement which the United States Supreme Court has twice been asked to review. Players, fans, parents, and lawmakers have joined in calling on the NFL to do more to address the seriousness of traumatic brain injuries in the sport. Recently, The New York Times has reported that the NFL has tried to answer that call by spending $100 million in addition to a previous $100 million for the development of new technology and research related to head injuries.

Purpose of Additional Funds

After immense pressure and public outcry that previous funds have been used for self-serving purposes instead of addressing issues they were meant to address, the NFL has promised an additional $100 million in funding which it says will be used for “independent medical research and engineering advances” that are meant to address “prevention, diagnosis and treatment of head injuries; enhance medical protocols; and further improve the way the game is taught and played by all who love it.” Previous funding had been used for new equipment and long-term studies related to the impact of repeated concussions and head traumas. Critics have pointed out that funding for helmet improvements has done little to improve player safety because helmets are primarily meant to prevent skull fractures and do little to address the concern of repeated concussion and related side effects. To avoid continuing criticism of the way the new funds will be used, the NFL has also said that details related to the use of the new funding will be shared publicly.

Many of us believe that death of an individual is when the individual’s heart stops or when they stop breathing. However, life support systems can keep the heart and lungs working even after the brain cease to function. Life support systems are mechanical means used to pump the heart and breathe for the patient who cannot do so on his own. If the brain cannot support these systems after the machines are unplugged, than the individual may be considered “clinically” brain dead.

Clinical brain death is the irreversible loss of the brain functions that are necessary to sustain life. When asked what the purpose was for keeping a patient on life support who was medically determined to be clinically brain dead, physicians state that often it is done in order to allow family members time to say their last goodbyes to their loved one, or it may be for the purpose of providing enough time to allow family member to determine if any of the patient’s organs will be donated. See Plain Views for more information on this subject.
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Save this date: March 16, 2016. This coming March 16 is National Brain Injury Awareness Day. This is an annual event where advocates for the care and treatment of Traumatic Brain Injury in America, such as the Brain Injury Association of America (BIAA) meet on Capitol Hill in Washington D.C. for the purpose of (1) increasing Congressional awareness of the special needs of those suffering from brain injuries; (2) to provide information and resources to brain injury sufferers and their caregivers; (3) to bring to light the need for better care and treatment for brain injury sufferers, including civilian and military individuals; and (4) to expand brain injury research and resources for state run programs.

The Treatment and Care of Brain Injury Sufferers is a Major Concern
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Advocates for the treatment of Traumatic Brain Injuries (TBI) are celebrating a victory with the passage of the Traumatic Brain Injury Reauthorization Act of 2014 by the U.S. House of Representatives. The Brain Injury Association of America (BIAA) made the announcement last week, stating that it is an accomplishment several years in the making. According to an NBC News report, the passage of the Act will mean continued federal funding for prevention and education, as well as research and treatment initiatives.

Susan Connors is President and CEO of BIAA. She is included in the article as stating, “The passage of this reauthorization of the TBI Act means that research relating to children with brain injuries will gain more attention. TBI prevention and surveillance programs at CDC will continue, as will the state grant program and protection and advocacy grant program currently administered by the Health Resources and Services Administration (HRSA).” She also added her appreciation grassroots TBI organizations, “without whom this would not have been possible.”

Under the legislation, the following authorizations would occur:
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As part on an ongoing effort to protect servicemembers from serious injury, the army recently revealed the prototype of a new helmet that was specifically designed to prevent traumatic brain injuries (TBI). The Conformal Integrated Protective Headgear System includes a jaw protector and face visor to provide a more comprehensive level of safety for the soldier. However, despite the efforts of developers, testers determined that the helmets may prove more harmful than protective.

According to an article in The Blaze, the Naval Research Laboratory (NRL) determined that the changes to the helmet, while more protective of the face, are not adequate in protecting the head from the potentially devastating effects of a blast. In conducting the tests, researchers used gelled test dummies. After equipping them with the helmets, explosives were set off from a distance to simulate the the types of blasts that a soldier may encounter during battle. The findings showed that the resulting pressure on the brain was not significantly decreased.
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It turns out that the rock band Quiet Riot was possibly on to something when they sang, “Bang your head! Medal’s gonna drive you mad!” While banging your head to your favorite hard rock artist may not drive you mad, according to recent reports, it can give you a traumatic brain injury. The US News and World Report is reporting that the head banging of a hard rock enthusiast led to a serious brain injury. The Motorhead fan arrived at a German hospital with complaints of increasingly painful headaches. At 50 years old, he reportedly had no medical history of head injury. He informed physicians that he was a regular head banger, who recently attended a concert with his son.

The doctor’s conducted a head scan, which reportedly revealed a blood clot inside of the brain. The initial treatment involved removing the blood clot and allowing the blood to drain. In the months following, the man’s headaches dissipated. During a follow-up visit, an additional scan showed a benign cyst. Doctors reportedly concluded that the cyst possibly increased his risk for brain injury and repeated head banging sealed the deal.
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A new report suggests a link between traumatic brain injuries and dementia. According to an article by US News and World Report, veterans who have experienced a traumatic brain injury are more likely to develop dementia later in life. The study findings additionally state that these former soldiers are 60 times more likely to develop dementia earlier in life than their counterparts who have never been diagnosed with any brain injury.

The study involved the examination of 190,000 veterans, who were all free of dementia. The average age of the participants was 68-years-old. According to the report, 1,299 of these vets had a traumatic brain injury diagnosis. The participants were followed over a nine year period. During that time, researchers found that 16% of the veterans with brain injuries developed dementia, while only 10% of those without a brain injury developed dementia. The findings all showed that the brain injury subjects developed dementia at an average age of 78.5, while dementia did not set in for the other subjects until the average age of 81-years-old.
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Picture this: A high-powered business executive and his assistant have just arrived in Chicago for a conference. They rent a car at O’Hare and head down the highway toward their downtown hotel. The pair cruise down I-94 at a good speed because traffic is relatively light. Then, out of nowhere a taxi cab slams into the side of their rental car. The pair’s vehicle is thrown hard right and collides nearly head-on with the concrete side wall on the highway.

Investigations show that the taxi driver was obviously negligent. He attempted to change lanes without paying attention, swerving without realizing that the pair’s car was next to his.

The executive and his assistant suffer very serious traumatic brain injuries in the car accident. Their airbags deployed, but that did not prevent their heads from colliding with the hard interior of the car. Both will requires month of surgery and rehabilitation, and their ultimate ability to regain full functioning is unclear.

Even though the debate both in and out of the courtroom has raged for years, the matter of brain injury and physical sports is far from over. For example, just this week the New York Times published a new piece on the helmet manufacturers who are under intense scrutiny. In particular, many questions are being raised about the need for clear, unambiguous warning labels to ensure all sporting participants, particularly football players, are aware of the risk of serious brain, neck, and spine injury.

How Blunt Should Warnings Be?

The current debate focuses not on the existence of warning labels–all helmets have them in some form–but on the nature of the language itself. Most consumers rarely read these warnings, and, even when they do, the text is often so convoluted and watered down that few appreciate the details.

DOD Live reported this weekend on developments coming out of the United States Department of Defense on the brain injury research front. As we have previously discussed, the Department of Defense is keenly interested in the issue, as brain injuries of different form are the number one injury affecting soldiers fighting overseas in Iraq and Afghanistan. But for so common an injury, specific understanding of the causes and best practices for treatment are few and far between.

Recently, the Department convened a symposium with a wide range of groups and individuals at the forefront of brain injury research. The event sought to discuss possible collaborations and generally point toward the future when it comes to treating traumatic brain injuries.

As a result of the event, the DOD decided to launch the first “brain tissue repository” in the hopes of compiling a systematic record to understand the injury and ultimately find cures.

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