MARCH WAS BRAIN INJURY AWARENESS
By The Jere Beasley Report, April 2011
Each year, millions of people in the United States sustain traumatic brain injuries (TBI) from falls, motor vehicle traffic crashes, collisions with moving or stationary objects, and assaults. The Centers for Disease Control and Prevention (CDC) estimates TBI will affect 1.7 million people, resulting in 1.365 million emergency room visits: 275,000 hospitalizations, and 52,000 deaths every year. In order to bring awareness to brain injury and the lives of those affected by it, March is designated as national Brain Injury Awareness Month. This year, for the first time, Alabama has also specifically designated March as Brain Injury Awareness Month in the state, with a proclamation from Gov. Robert Bentley. Statistics show what nearly 10,000 people in Alabama receive a brain injury every year, resulting in 500 deaths and 1,500 disabilities among children and adults.
“Brain Injury Awareness Month honors the millions of survivors who, with proper acute care, therapeutic rehabilitation and adequate long-term supports, are living with brain injury every day,” said Susan H. Connors, president and CEO of the Brain Injury Association of America. Goals for the statewide recognition of Brain Injury Awareness Month include honoring Alabama’s citizens with Traumatic Brain Injury and their families, and increasing awareness to the general population about brain injury through the Alabama Head Injury Task Force.
The Task Force is a statewide advisory board for TBI, established in 1989 by the commissioner of the Alabama Department of Rehabilitation Services (ADRS). Its mission is to develop the ideal service delivery system for Alabamians who experience a TBI. Brain injury affects people in ways that are invisible, that no one understands and it is often called the hidden disability. Carol Stanley, who is an employee with our firm, began crusading for awareness about TBI after her son, Jason, was injured during a violent crime. Carol is active with the Alabama Head Injury Task Force and we at Beasley Allen are proud of her. Carol had this to say:
A brain injury is a forever life-altering experience for the TBI survivors and their families. Many characteristics of the brain injury impairment are not always familiar, and are not obvious to the general public, medical system, education system, legal system, judicial system, law enforcement and so on. My son’s TBI journey has taken us down all those avenues, and this is why I feel TBI education and awareness for all people is so very important.
Members of the Task Force include people with TBI, their family members, the Alabama Head Injury Foundation, the University of Alabama at Birmingham (UAB) TBI Model System, the Alabama Disabilities Advocacy Program, and the Coalition of Domestic Violence. The group also includes such state agencies as the Department of Human Resources, the Department of Mental Health, the Department of Senior Services, and the Alabama Medicaid Agency. According to Charles Priest, executive director of the Alabama Head Injury Foundation (AHIF):
Due to recent events including concussions in the NFL, the assassination attempt on Congresswoman Giffords and the return of our “wounded warriors”, the awareness of traumatic brain injury is increasing. The Alabama Head Injury Foundation is responding with a new focus on safety and prevention through care seat campaigns and sports concussion education. We welcome the opportunity to coordinate the activities for Brain Injury Awareness Month in Alabama.
A person who has sustained a brain injury may access a specialized statewide network of staff who can work with the individual and his or her family to educate them about the brain injury and provide services and support. For more information, contact Maria Crowley, State Head Injury Coordinator, at 205-290-4590 or email her at maria.crowley@rehab.alabama.gov. Information about TBI also was featured throughout the month of March on our firm’s Personal Injury and Product Liability website at www.southerninjurylawyer.com.
Low Apgar Scores and ADHD.
Source: Journal Pediatrics, 2011.
A recent study by Danish researchers of the Department of Epidemiology, School of Public Health, University of Aarhus, concludes that a low Apgar score is associated with an increased risk of ADHD in childhood. What does it all mean?
The Apgar score was devised in 1952 by Dr. Virginia Apgar (an anesthesiologist) to simply and repeatably assess the health of a newborn in the delivery room. While it has come under question in some circles as to whether an Apgar score means anything at all, the score is a subjective number assignment (0 to 10) of Appearance (color, etc.), Pulse, Grimace (facial movements or crying), Activity (movement) and Respiration (breathing). It is usually taken at 5 minutes of life. And repeated.
While it is clear that a score of zero is incompatible with describing life, it is debatable what a low Apgar score (say a 4) means to an infant’s future development. It is after all their first graded test.
Enter the Danes. The researchers decided to determine whether low Apgar scores at 5 minutes are associated with increased risks of attention deficit hyperactivity disorder (ADHD) in the future. The study was a nationwide (Denmark for the Euro-ignorant) population-based cohort study of 980,902 babies born in Denmark from 1988 to 2001. All children were monitored from 3 years of age until a first International Classification of Diseases diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first.
Their results? Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with Apgar scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15-2.11) and 63% higher for those with Apgar scores of 5 to 6 (95% CI: 1.25-2.11). Consider that 5% of all children are diagnosed with the disorder.
But why? There the research is not as complete. Speculation includes: poor maternal nutrition and prenatal (prior to birth) medical care; asphyxia (lack of oxygen); small brain hemorrhage; shock or trauma -any one of which could result in a subjectively lower score by the observer.
Post: David M. Schwadron, Esquire
Brain Cooling for Strokes?
Source: BBC Health News -Scotland
And you thought all the Scots were good for was Scotch and skirts? Dr. Malcolm Macleod (of the clan Macleod) is one of several Scottish physicians supporting the idea of cooling the brains of stroke victims –a process which a growing body of research suggests may dramatically improve recovery of brain function.
That’s correct, inducing hypothermia in some patients can boost survival rates and reduce brain damage. To date, studies have involved the body of patients being cooled using ice cold intravenous drips and cooling pads applied to the skin.
This lowers the body temperature to about 35C, just a couple of degrees below its normal level.
At such low temperatures, the body into a state of artificial hibernation, where the brain can survive with less blood supply, giving doctors vital time to treat blocked or burst blood vessels.
Dr Malcolm Macleod, head of experimental neuroscience at the Centre for Clinical Brain Sciences at the University of Edinburgh, said: “Every day 1,000 Europeans die from stroke – that’s one every 90 seconds – and about twice that number survive but are disabled. And, “Our estimates are that hypothermia might improve the outcome for more than 40,000 Europeans every year.”
Dr. Macleod and his Highlander Scottish team are joining a consortium of clinicians from across Europe to seek funding for a trial involving 1,500 stroke patients. The European research project, will also include hospitals in Germany, Italy and France.
~Posted by D.M. Schwadron, Esquire
New test for Alzheimer’s Disease?
Source: AARP Bulletin, July 2010
Who says there’s no more creativity in American business?
Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. (He forgot about it shortly thereafter. Kidding!) Alzheimer’s is a progressive and fatal brain disease. As many as 5.3 million Americans have Alzheimer’s disease. Alzheimer’s destroys brain cells, causing memory loss and problems with thinking and behavior severe enough to affect work, lifelong hobbies or social life. It is the seventh-leading cause of death in the United States.
The most common form of the disease is dementia (general memory loss) which interferes with daily life. The disease is currently without a cure.
A small company in Philadelphia (of all places), Avid Radiopharmaceuticals, has offered information on a radioactive dye which may be used in connection with currently existing PET scan technology. The dye “sticks” to the plaques (a protein known as beta-amyloid) on the brain which are associated with Alzheimer’s and appear whiter on the scan. Reportedly, the dye finds and highlights plaques in 97% of the PET scans.
The test, if approved for marketing by the US Food & Drug Administration, could help diagnose the disease in its early stages to allow for medical intervention. For those suffering along with a family member who has Alzheimer’s the value of added time can not be denied.
~Posted by D.M. Schwadron, Esquire
From across the Pond -IQ and infant resuscitation
A little too close to home here, but results of a recent British cohort study suggest that infants who required resuscitation are at increased risk for low IQ scores by 8 years of age.
Significantly, the results were said to be similar for those infants with and without encephalopathy. The theory advanced to explain this is called “continuum of reproductive casualty” meaning that even mild perinatal events may have long term effects on cognition. The study ultimately examined the IQ scores of 5887 children in a British school who were around 8.6 years of age on average.
Up to 14% of neonates may require resuscitation after delivery. Mine did. It should be noted that children delivered more than 8 years ago were more likely to receive 100% oxygen during resuscitation. Such a level of forced oxygenation was associated with poorer outcomes, forcing a practice change. Still, in calling the results “surprising” clinicians have noted some limitations of the study in that only 51% of the original cohort group of 10,609 children were followed to school age (British system school age) and that the mean (average) IQ scores among the resuscitated and asymptomatic children were not different from the control group.
My neonate is currently 5.6 years of age. One to follow.
posted by David Marc Schwadron, Esq.