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NASCAR and Head Injuries

posted by SK Brain Injury    |   February 22, 2012 17:26

If Michael Waltrip were to count up all the concussions he has sustained over a NASCAR career that stretches back nearly 30 years, he'd certainly hit 10 — and probably keep going.

Safety measures since Dale Earnhardt's death in 2001 have gone a long way toward preventing head injuries, and NASCAR officials have taken steps to improve the way they identify and treat concussions. But Waltrip knows that won't undo all those hits he took in the 1980s and '90s.

"I whacked my head — a lot," Waltrip said. "If you think about this, I showed up in '85, when it was relatively 'safe.' We thought we had it figured out. I raced all the way through 2001 when people were getting killed. And all through that time, I was hitting my head and knocking myself out and getting concussions and going to the hospital. And I don't know what that means to me in 10 years. But I know it's a concern."

The 48-year-old Waltrip gets uneasy when he hears stories about NFL players and other athletes who are having serious neurological problems after they retire, issues that a growing amount of research indicates may have been caused by repetitive brain injuries they sustained during their playing days.

Could that happen to him, too?

"I would be the perfect case study to see what's going to happen," Waltrip said. "Because I can go back and look at the races and count up times I was knocked unconscious that I can't count on both hands."

Five-time NASCAR champion Jimmie Johnson says he has had two concussions racing stock cars, and probably many more racing dirt bikes when he was younger.

"We're not immune to concussions," Johnson said. "And certainly after severe concussions or being concussed several times, the numbers change. We know that. The dynamic is there. I think we've reduced the opportunity for it to happen, but ultimately, it can happen. I just think the odds are a lot better today than they've ever been."

Earnhardt's death in the 2001 Daytona 500 — which came after drivers Kenny Irwin, Adam Petty and Tony Roper all were killed from similar head injuries — forced NASCAR to get serious about safety.

Today, drivers must wear a head and neck restraint, while impact-absorbing SAFER barriers have been installed on racetrack walls and NASCAR completely redesigned race cars to reduce the risk of injury. Racing seats used to look a lot like passenger car seats; now they look more like something out of a spaceship, with foam-padded supports on each side of the helmet that barely allows a driver's head to move during a crash.

It's working. Going into Sunday's Daytona 500, there hasn't been a death in NASCAR's top three national series since Earnhardt's.

"If I'm Kasey Kahne or Kyle Busch, I don't have those concerns any more," Waltrip said. "We've got the cars and the tracks, we've got it all fixed. You can still get hurt. You're running 200 miles an hour. But the chances of getting hurt are slimmer. The chances of hitting your head and hurting it are really slim."

NASCAR officials say they've identified 29 concussions in their top three series since 2004 — and only 11 of those happened in the past five seasons.

"Not huge numbers, when you see it," said Steve O'Donnell, NASCAR's senior vice president of racing operations. "But with each of those, each one's different, we've had to assess each one differently. Knock on wood, we haven't had as many to have to deal with."

And while there have been some drivers who experienced long-term effects from traumatic head injuries over the years — including Bobby Allison, Ernie Irvan, Jerry Nadeau and Steve Park — O'Donnell says NASCAR doesn't see any evidence of widespread health issues related to multiple head injuries, as the NFL and other sports are.

"There's always concerns for any driver that's been in the sport," O'Donnell said. "But in terms of drivers formally approaching us and saying, 'Hey, I want to talk about this or look at it,' we haven't seen that occur, in terms of what you're seeing in other sports right now. We'd certainly be open to working with anyone, if we see that, in helping to stop any trend that we saw."

In response to reports of football players, hockey players and other athletes having serious neurological issues in retirement, researchers at the Boston-based Sports Legacy Institute have studied brain tissue of deceased former athletes. They've found evidence of a degenerative brain disease known as Chronic Traumatic Encephalopathy that has been linked to repetitive brain injuries.

O'Donnell said NASCAR officials have noticed.

"Absolutely," O'Donnell said. "It's something we pay attention to on any aspect of other sports, what they're doing. Can we learn from it? Can we implement some of these things? We're open to working with any other sport as well."

For now, veteran driver Jeff Burton is trying to gather as much information as he can about the long-term effects of concussions. Burton's father-in-law is a physician and has attended sports medicine conferences on his behalf.

"I think anybody that has any sense at all has to understand that it doesn't matter if you're playing football or hockey or racing a car, head injuries can have bad ramifications later in life," Burton said. "It appears to be the case. I think we are exposed to less of it. But at the same time, when we do have them, they can be big hits."

The 44-year-old Burton started racing in NASCAR's top division in 1993, well before the post-Earnhardt safety advances.

"I can tell you that in retrospect, there's been many times that I've had concussions," Burton said. "And the definition of concussion is a very widely used term, and how you actually define a concussion has changed over the years. But there's no question that with hitting concrete, not having (today's safety equipment), there's no question people had concussions. No question."

Waltrip said he blacked out after an accident in practice at Las Vegas in 1998, but kept it to himself.

"Hit the wall, got in the backup car, made a couple laps, went to the hotel, woke up the next morning, didn't even know how I got there," Waltrip said. "You could just fake people out back then. 'Yeah, I'm fine, I'm fine.' They didn't care. 'OK, you're fine.'"

Today, any driver involved in a significant accident must visit the infield medical center, where checking for signs of a concussion is standard procedure. If there's reason to suspect a concussion, the driver will be sent to a local hospital. From there, the driver will need to be cleared by a neurosurgeon with at least five years' experience in sports-related head injuries before he or she can race again.

"They always ask you," Burton said. "The key to that, though, is honesty. Unless it's obvious. Sometimes you can tell. But a lot of times, in football and in every sport, people say, 'I'm fine.' It's hard if you don't tell them the truth to help you."

Burton acknowledged that drivers, along with athletes in other sports, have an incentive to hide symptoms.

"There's fear in not being able to do what you want to do," Burton said. "NASCAR's always been really good saying, 'Look, we don't want to keep you from racing unless it's in your best interests.' They've been pretty good about that. People are always nervous, I think, in any sport to stand up and say I'm having these issues, because they want to race or they want to play. But if NASCAR doesn't want you to race, then you probably shouldn't be racing."

Article found at the Tahlequan Daily Press

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Link Between Brain Injury and Addiction Studied

posted by SK Brain Injury    |   February 16, 2012 11:10

When Dr. Gabor Mate began to investigate the medical literature about brain injury and addictions, he was expecting to find addictions could develop after acquiring a brain injury, but he discovered the opposite was true.

The reality is many people who end up with a brain injury have substance abuse issues already, he said.

"Brain injuries happen mostly to young men and they tend to have a history of substance abuse. When you look at the literature you'll find drug use tends to predate the injury," he said.

Mate will be presenting his research findings today at the 22nd Pacific Brain Injury Conference, which continues Friday at the Sheraton Vancouver Wall Centre.

"It means [some] people ending up with traumatic brain injuries tend to have pre-existing addictions. With that understanding we need to look at the childhood risk factors in a preventive sense. There's a lot more we can do to prevent brain injuries by looking at the kids who are at risk because of family circumstances, learning disabilities, behavioural manifestations, emotional dysfunction. This can be intervened in a positive way if we had a preventive system in place," he said.

But Mate said the kids who are most likely to engage in risky behaviour are either not identified early enough or simply being told drinking or drug use is bad, which isn't an effective deterrent.

Mate added there have also been studies showing a high percentage of incarcerated individuals have suffered a brain injury. He pointed out an American expert on trauma once reported "people with childhood trauma, abuse and neglect make up almost the entire justice population in the U.S." An Australian study in 2006 found 82 per cent of prisoners inter-viewed had suffered a traumatic brain injury, he added.

Given the evidence, Mate said the federal government's plan to increase penalties for drug possession as part of its tough-on-crime legislation is the wrong approach to dealing with sub-stance abuse.

"The government's drive is to build more prisons. We're jailing people who were traumatized as children instead of providing rehabilitation," said Mate.

Other US studies have shown incarceration rates of brain injured people vary from 78 per cent in Ohio to 86 per cent in Tacoma, Wash., said John Simpson, of the Fraser Valley Brain Injury Association.

Simpson has been visiting prisons in B.C. since 1991 offering support to inmates and providing in-service training for staff on how to recognize signs of brain injury.

"It's the same here in Canada. The men I've met and interviewed are truly the walking wounded. The vast majority have no visible signs of a brain injury. They look perfectly normal on the outside but only when you begin talking to them you see some have speech difficulties, behavioural or cognitive problems," said Simpson.

Unfortunately, many go unidentified in prison and are seen as having behavioural problems when the root cause is a brain injury and no rehabilitation is offered, he said.

Simpson also agreed more prisons are not the answer.

"You don't need bigger and better prisons. You need bigger and better programs in the community."

The Fraser Valley Brain Injury Association is beginning a new support group for inmates with a brain injury at Mission Institution in the coming weeks. Simpson said it used to have a very active program there but two of the inmates who were key members of the group moved to a minimum security prison. He added both of those men had suffered brain injuries as youths when they were both severely beaten by step-fathers. One also had been involved in a car crash and another suffered a concussion in sports.

Article from The Vancouver Sun

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Connections - Winter 2012

posted by SK Brain Injury    |   February 9, 2012 11:07

Attached is the latest edition of Connections! Inside you'll find information about various upcoming events including the Spring Retreat and Brain Blitz.

winter2012.pdf (568.20 kb)



Brain Injury in US Prisoners

posted by SK Brain Injury    |   February 8, 2012 10:17

A car accident, a rough tackle, an unexpected tumble. The number of ways to bang up the brain are almost as numerous as the people who sustain these injuries. And only recently has it become clear just how damaging a seemingly minor knock can be. Traumatic brain injury (TBI) is no longer just a condition acknowledged in military personnel or football players and other professional athletes. Each year some 1.7 million civilians will suffer an injury that disrupts the function of their brains, qualifying it as a TBI.

About 8.5 percent of U.S. non-incarcerated adults have a history of TBI, and about 2 percent of the greater population is currently suffering from some sort of disability because of their injury.

In prisons, however, approximately 60 percent of adults have had at least one TBI—and even higher prevalence has been reported in some systems. These injuries, which can alter behavior, emotion and impulse control, can keep prisoners behind bars longer and increases the odds they will end up there again. Although the majority of people who suffer a TBI will not end up in the criminal justice system, each one who does costs states an average of $29,000 a year.

With more than two million people in the U.S. currently locked up—and millions more lingering in the justice system on probation or supervision—the widespread issue of TBI in prison populations is starting to gain wider attention.

A few pioneering programs offering rehabilitation to prisoners—and education to families and correctional staff about TBI—are underway around the country. And several studies aim to ascertain the best ways to handle this huge population. "It's not as cut-and-dry as a lot of people think," says Elisabeth Pickelsimer, an associate professor at the Medical University of South Carolina. Some of the best options so far include cognitive therapy for prisoners and education for the people around them.

The kicker seems clear to many researchers: "If we don't help individuals specifically who have significant brain injuries that have impacted their criminal behavior, then we're missing an opportunity to short-circuit a cycle," says Peter Klinkhammer, associate director of services at the Brain Injury Association of Minnesota.

One hard knock 

Concussions are the most common type of brain injury, and about 85 percent of people who suffer one will more or less fully recover within a year. But for those who do not, lingering symptoms, such as headaches or increased irritability, can get in the way of everyday functioning.

Many of the behavioral issues that result from a TBI are due to the nature of the impact itself. In an accident or altercation, the brunt of the blow is often borne by the front or top of the head—right around the frontal lobes where behavior is regulated.


Interactive by Ryan Reid 

This sort of injury can be loosely compared with a computer glitch: "If something went wrong with the central processing unit, it might be slower—you couldn't save documents as easily—but it might chug along," says Wayne Gordon, a professor of rehabilitation medicine at Mount Sinai School of Medicine. Traumatic brain injury can lead to attentional and memory deficits as well as increased anger, impulsivity and irritability—which make for a poor match with the corrections world.

One of the big challenges in addressing TBI in prison populations, and beyond, is that it is not as easy to diagnose as a broken bone or a blood-borne illness. Symptoms are by no means unique to the injury and can be co-occurring with other mental health conditions. To make things even tougher for those hoping to track the disability, no two brain injuries are alike. "Two people can have the same injury and have a totally different set of impairments," Gordon says. "One can be fine, and one can be not so fine—but we don't know why that is yet." He suggests that differential responses could be due to a combination of physical, genetic, contextual and social factors, such as skull thickness, the magnitude of g-forces involved in the impact or past history of more minor, sub-concussive injuries.

Due in part to these variables, not all TBIs result in a medical paper trail. Doctors treating people with serious wounds might miss diagnosing a brain injury, and hospitals do not always code for every presenting condition. Also, many people who suffer a head injury, especially a milder one, such as a concussion, might not seek medical attention at all.

Researchers have started using detailed interviews with prisoners to get a better sense of how many have suffered from a brain injury. In a recent South Carolina survey of 636 prisoners, some 65 percent of males and 73 percent of females reported having sustained TBIs at some point in their lives. Injury counts are likely underestimated. Many people, for example, are unaware of injuries that they might have sustained when they were babies or young children. And even adulthood injuries were not entirely clear to prisoners. "They were told they had their bell rung—they got knocked out," says Rebecca Desrocher, assistant program director at the U.S. Department of Health and Human Services's Federal Traumatic Brain Injury Program.

The very nature of brain injuries can also make tracking them—and figuring out how many an individual might have suffered—especially difficult. As Pickelsimer points out, "after you've had some, you don't remember them as clearly." These injuries are additive, with each assault to the brain compounding damage from the previous ones. The average reported number of TBIs for an individual prisoner was about four, Pickelsimer says. And some reported up to a dozen.

Through these interviews, Pickelsimer says, another thing became clear: prisoners were often not aware that a single event—or a series of them—could be making it harder for them to earn a ticket out of jail, or avoid being sent back in the future.

Bad behavior 

As much as TBI seems to increase the likelihood that a person will wind up in prison, it also seems to make the corrections environment that much more difficult to navigate. In prison, "there's so much that goes on a day-to-day basis: 'Line up over here; do this; do that,'" says David Maltman, a policy analyst at the Washington State Developmental Disabilities Council. When a prisoner with TBI is misremembering rules or is slow in responding to instruction, many prison staff are likely to see a prisoner as noncompliant or intentionally defiant, provoking situations that can lead to further injury—or at least poorer chances at an early release.

Brian injury also increases the likelihood that people will have other mental health troubles, including substance abuse, and can also make it more difficult to overcome additional conditions. In a survey of adults enrolled in a New York State substance abuse program, about half had a record of TBI, Gordon says. The screening that Pickelsimer and her colleagues have done in South Carolina found that for both men and women, alcohol and crack cocaine were among the most common substances to which TBI prisoners were addicted. And these habits can cloud a person's memory of brain injuries they might have suffered in accidents, altercations or other incidents, which makes accurate diagnosis even more challenging. For those getting substance abuse treatment, a TBI can also make traditional rehab programs less effective. With the "reduced processing speed and their memory challenges," Gordon says, lessons might need to be altered or even repeated for enrolled prisoners with a history of TBI.

The behavioral and other cognitive changes that TBI can bring, "if left unaddressed, are apt to provide challenges to the offender post-release as they attempt to reintegrate into their respective communities," notes Adam Piccolino, a neuropsychologist for the Minnesota Department of Corrections.

Bridge to the outside

Treating TBI in the broad adult population is not a perfect science. The goal is to "supply them with skills they need to better regulate their behavior and process information," Gordon explains. It often involves cognitive retraining and rehabilitation—and has imperfect results. And as he points out, these therapies have yet to be thoroughly tested on incarcerated populations.

Others argue that tools that seem to work in the broader population should be used in prisons as well. Cognitive rehabilitation therapy is one such tool that seems to be gaining traction in the TBI field. It aims to help those TBI sufferers make better-informed choices and to improve memory. And with such minimal knowledge about TBI and its symptoms, simply educating inmates about their—and others'—condition might go a long way in helping them cope with related challenges, Desrocher says.

Even with proper education and therapy, though, people with TBI will often experience behavioral issues. So many groups have put an emphasis on training staff—and even arresting officers—to handle these sorts of prisoners better in hopes that they "can recognize a behavior for what it is—and not defiance of an infraction of the rules," Maltman says. Resulting altercations can put law and corrections staff—and fellow prisoners—at risk for injury.

But knowing which prisoners might benefit from alternative approaches requires thorough screening processes that are either highly variable across institutions or entirely absent. "Additionally," Piccolino notes, "once an offender is identified with having incurred a TBI, the process of knowing whether they also experience ongoing complications related to their TBI is challenging."

Some organizations, such as the Brain Injury Association of Minnesota, have gone a step further and are also working with prisoners' family members, probation officers and outside support services to ready ex-convicts for release. Klinkhammer notes that for prisoners with TBI, returning to the outside world can be an extremely difficult transition. Once predictable prison routines disappear, he explains, it's almost like Dorothy going from her black-and-white reality in Kansas to the colorized world in Oz. Although that shift might sound like a blessing, for those with a brain injury who have difficulty managing their reactions or processing a lot of incoming information quickly, the new environment can be too much. "It can be very overwhelming, and it could result in one or more reason for a person to 'recidivize'"— do something that will land them back in jail, even if they had no intention of breaking the law— Klinkhammer says.

Much of his group's efforts come down to education and helping family and other community members learn how to support a prisoner with TBI returning to the outside world. And oftentimes just explaining to them that an old injury might be contributing to unpredictable behavior is a big help. "People know that their loved one's been knocked out" or were in a car accident years before, Klinkhammer says. "But the thought that the outcome of that may result in disinhibition or that it could be an aggravating factor to a person's criminal behavior gets lost."

The group does not yet have formal data on the success of the program, but from his observations, Klinkhammer says, "individuals are doing better when they are able to dovetail back into society in a way that they're supported." The key is "making sure that when people step out into the community they're not falling into an abyss," he says. And "in doing that, we're also helping society at large stay safer."

Earlier intervention

Once a person with TBI is behind bars, arguing for a chunk of shrinking budgets to help them out is not always an easy sell. In South Carolina, for example, once a person is identified as having TBI, the department of corrections is obligated to provide extra resources for them. "It's cheaper for them to just lock them up," Pickelsimer says.

In her estimation, "the intervention has to be when they are much younger"—before they commit a crime, by encouraging teenagers to stay in school and not have children until they are prepared to provide and care for them. By doing that, she says, the next generation will be less likely to fall into a cycle of injury and crime.

Gordon would extend this early intervention to screening, too. In his research on TBI in substance abusers, participants who had multiple brain injuries tended to be in their 30s. But, he says, "the average age when they had their first injury was 14." If their injury had been identified—and they had received any necessary assistance—earlier, future substance abuse and behavioral issues might have been avoided altogether. This, he says, is an example of "using screening and identification as prevention—and what you're preventing is social failure." That social failure due to TBI is not limited to the corrections world, he notes: "In any group of folks who are failing—substance abuse, the hardcore unemployed—I would say, the prevalence of TBI is very high." Early diagnosis does not necessarily require expensive intervention, he says.

Treatment for those already in trouble can also start younger. An experimental program in El Paso, Texas, adapted a TBI cognitive treatment program for juvenile offenders. The goal was "to try to teach them how to be in touch with their own sensations and activities so they can learn to stop and think before they act—and then consciously choose a choice and evaluate whether that was the right choice," Gordon explains. When administered to kids—both those who had a history of TBI and those who did not—there was a fivefold reduction in recidivism, he reports.

The Traumatic Brain Injury Act of 1996 carried provisions to help reduce the incidence of TBI and improve psychological treatment, and in 2000 it was expanded to include education about prevention—especially to parents. A 2008 reauthorization of the act added a mandate to study TBI prevalence among institutionalized populations, which includes prisons but also nursing homes and other institutions where people reside. But studies have been slow to materialize. Minnesota is currently assessing data from their prison population to determine how much TBI affects substance abuse treatment completion, use of medical and mental health resources, and rates of recidivism.

One of the first steps to better understanding TBI in these populations, however, is to boost screening—as well as ensure that such monitoring is scientifically sound and widespread. And just demonstrating the value of screening might take years, Desrocher says. Her hope is that down the road, the data show that it is "not only [of] clinical value for the individual—but also a value for society."

Article from the Huffington Post



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A School in Cleveland will be Studying Brain Injury

posted by SK Brain Injury    |   February 6, 2012 10:48

Two competitive Ohio medical research institutions are teaming up at a new lab to study head and spinal injuries that occur in sports and combat.

The Cleveland Clinic and Case Western Reserve University will jointly run the Cleveland Traumatic Neuromechanics Consortium, working to learn more about the causes of head and neck injuries and to create better protection and treatment, The Plain Dealer reported Saturday.

“There are many more questions than answers” about brain injuries, said mechanical engineer Adam Bartsch, who leads the Clinic’s Head, Neck and Spine Research Laboratory. One of those questions is what level of force or number of repeated impacts causes temporary or permanent brain damage. There’s concern that injuries like concussions can cause lasting damage.

The lab will search for answers with specialized equipment, including an air-powered ram that will be used to test football helmets on replica human heads by mimicking certain impacts, such as a straight-line hit or an oblique, head-spinning blow from an aggressive NFL linebacker barreling into a quarterback, which some researchers suspect may be even more damaging.

Developing sensors for the test heads and simulations of how a brain reacts might help the researchers better understand what causes concussions, and that could pave the way for better rules or safety standards and improved helmets and other protective gear.

“There are things that can be done to the helmet that would be helpful in basically absorbing energy and protecting the head,” said Case Western mechanical and aerospace engineering professor Vikas Prakash, who has worked on creating better protective gear for military personnel and vehicles. “Engineering-wise, it’s very rich.”

Prakash and Bartsch, who are co-directing the joint research effort, unpacked the air-powered ram – known as a linear impacter – this week. Later they plan to add high-speed cameras and a ballistic air gun. That would allow them to study the type of brain injuries caused by roadside bombs through simulations of the shock-wave effects.

The number of concussions from sports and battlefield service has drawn attention to brain injury care in recent years. The Centers for Disease Control and Prevention reports athletic activities lead to nearly 4 million concussions a year. A study by the nonprofit Rand Corp. determined at least 320,000 U.S. troops that served in Iraq and Afghanistan during the past decade suffered probable concussions, the newspaper said.

Bartsch and Prakash said they will pursue funding for their research from government grants, private donors and organizations such as the National Football League and the Department of Defense.

Article from the Claims Journal

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Concussion on Everyone's Mind at All-Star Game

posted by SK Brain Injury    |   January 29, 2012 17:44

A break in the NHL's schedule hasn't come with a break from the focus on concussions.

Steven Stamkos and Claude Giroux -- two of the biggest names participating in the NHL's all-star weekend -- made an appearance at Friday's launch of the Bauer "Re-akt" helmet, which is designed to protect against rotational-force impacts. They both touched on the rash of concussions players have suffered recently.

"I think it was alarming the last year and a half the amount of concussions that are being diagnosed and the amount of time that guys are missing," said Stamkos. "Obviously, with (Sidney Crosby) and his situation, that opens up a lot more eyes as well and we talk about it more and people become more aware.

"I've really started to take an interest in knowing more about the technology and the equipment and what's the safest."

Giroux wore the "Re-akt" helmet for the final three games the Philadelphia Flyers played before the all-star break while Stamkos has so far just tried it in practice with the Tampa Bay Lightning. They'll both have it on for Sunday's all-star game at Scotiabank Place.

"It's a lot better than the helmet I had before," said Giroux. "I just feel more comfortable with it."

He missed four games earlier this season with a concussion and can sympathize with Pittsburgh Penguins star Sidney Crosby, who remains sidelined with a head injury. His absence is notable here this weekend.

"Concussions are just the worst injury," said Giroux. "You can't really control anything after that when it happens. I think just time, it's going to help him. That's pretty much all he can do."

Article from

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Brain Injury Effects on Children: Larger than Experts First Thought

posted by SK Brain Injury    |   January 24, 2012 11:15

Young children who suffer a severe head blow may not overcome the traumatic brain injury (TBI) as well as previously believed, and interventions may be needed even years after, according to two new studies out of Australia.

For the first study, Australian researchers looked at 56 children, 40 of whom were injured between ages 2 and 7 and the other 16 who served as a control group. They found that a decade after each of the 40 suffered a TBI, evidence persisted of intellectual deficits. The study is published this week in the journal Pediatrics online and will be included in February's issue.

They looked at the intellectual, adaptive and executive abilities of the children, as well as their social/behavioral skills. Those with severe TBI tested lowest on IQ exams compared to a control group — as much as 18 to 26 points lower. They also found that regardless of how serious the injury was, recovery "seemed to plateau in the five- to 10-year range," the researchers said.

A release announcing the findings noted that "this is important because it counters the theory that children 'grow into the deficits' and suggests that even many years post-TBI, intervention may be necessary and helpful."

Most of the children in this study were injured by car accidents or a serious fall. They were tested at the time of their injury, then tested again three, six and 18 months after the injury, as well as again at five years and 10 years.

The findings apply to major brain trauma, not to cases of mild concussion or bumps on the head.

"Most of the deficits occurred in higher learning skills such as organization, planning and reasoning, because these are centered in the frontal regions of the brain, which are most often affected in head injuries," wrote Alice Park on a blog for Time magazine.

"These regions are also the ones that develop fastest early in life, so any injury that disrupts the normal trajectory of nerve growth can have long-lasting effects," said lead author Vicki Anderson, director of critical care and neuroscience research at Murdoch Children's Research Institute in Melbourne, Australia. Scientists have long talked about the brain's plasticity and its remarkable ability to reroute signals when something injures the brain. Some researchers believe that injuries to very young children are more apt to be overcome for that very reason than brain injuries in older children and adults. But Anderson noted that young children's brains are not fully developed and, after injury, development lags and may not catch up. "If you look at the trajectory of improvement over time, normal kids have one trajectory, while those with brain injuries have the same trajectory but start out at a much lower point," Anderson told Time.

The study did note a positive: Brain development after a traumatic brain injury does not appear to grind to a halt, as some had theorized.

The other study, also published in Pediatrics this week, found that socioeconomic status might be an even stronger predictor of intellectual development than simply having suffered a traumatic injury to the brain. They told CNN that lower socioeconomic status, high parental stress and low parental involvement affect a child's recovery after TBI and that might account for it.

Article from Deseret News

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Canada Pledges $1.5 million to the Reduction of Concussion

posted by SK Brain Injury    |   January 23, 2012 11:39

The federal government will spend $1.5-million to help reduce concussions in kid's sports.

The money goes to ThinkFirst Canada, Hockey Canada, the Coaching Association of Canada and the Canadian Centre for Ethics in Sport to support efforts to reduce the rate and severity of sports-related head injuries.

Montreal Canadiens Max Pacioretty lies on the ice after being hit into a glass stanchion by Boston Bruins defenceman Zdeno Chara during the second period of NHL hockey play in Montreal, March 8, 2011.

The groups will work on increasing awareness of the problem among coaches, players and parents.

Among other things, they hope to develop guidelines for fitting helmets, and provide better information about the risks and signs of head injuries and when it's safe to return to playing after an injury.

The groups will look at the information about concussion and head injuries that's currently available and try to fill in any gaps.

Concussions in sports have become a hot topic in the last year, especially in the wake of the problems of NHL star Sidney Crosby, and the program aims to raise people's awareness and knowledge about head injuries.

Bal Gosal, the federal Minister of State for Sports, said it's estimated that 90 per cent of severe brain injuries can be prevented.

“We want our children to be active, healthy and have fun while participating in team sports and physical activity,” he said. “But we also want our children to be safe.”

The government says accidental injuries are the leading cause of death for people under the age of 19. More than 40 per cent of brain injuries in children and youth aged 10-19 years treated in hospital emergency departments result from sports and recreation activities.

Much of the new information will be aimed at producing low-cost or free information that can be easily downloaded, including a brain injury and concussion mobile app.

Article from the Globe and Mail

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What's the Appeal of Extreme Sports, Given the Risk?

posted by SK Brain Injury    |   January 20, 2012 19:11

They do it because they have to. They need the feeling of exertion, that head rush of air and attitude. They want what Warren Shouldice knows is hard to explain unless you flip head over skis, knees over board, and kick snow in the face of danger.

That’s what drew Shouldice to freestyle aerials and helped him become a world champion after he had broken his neck and compressed his back. It’s what powered the late Sarah Burke to four Winter X Games championships and made her a success in the superpipe, skiing’s answer to snowboarding’s half-pipe.

“It’s almost no fun doing it if there’s no risk involved,” said Shouldice, a 12-time World Cup medalist in a daredevil game. “The trick is making it a manageable risk.”

When Burke died Thursday, nine days after falling during a training run in Park City, Utah, it saddened a nation and a sporting community world-wide. Burke was 29 and happily prepping for her sport’s inclusion in the 2014 Sochi Olympics. She had been injured many times before – a broken back, a torn shoulder – but nothing could dampen her love of skiing and the need to push herself to the brink of manageable risk and beyond.

Such is the appeal of many established and extreme sports, both for participants and spectators. The risks and rewards provide the thrills. Alpine skiing, particularly the ultra-fast downhill, has been a major attraction for decades. But the advent of the X Games upped the adrenalin quotient considerably.

The Games were the brainchild of ESPN producer Ron Semiao. In 1993, Semiao was looking for programming to fill the cable channel’s fledgling ESPN2. He spotted a series of oddball sports that seemed to have a culture all their own and suggested to his bosses that ESPN create a made-for-TV sporting event. Two years later ESPN launched the first Extreme Games, a week-long competition that featured bungee jumping, mountain biking, skateboarding and street luge. Ratings weren’t great and some critics panned the spectacle as “moronic.” But ESPN stuck with it and made the games an annual event, later adding a second winter sports program. It also changed the name to X Games.

The popularity of the X Games took off and today they rival the Olympics in some respects. The X Games pull in more than 100,000 spectators and draw a television audience of around 44 million. They have also attracted major sponsors such as Ford, BF Goodrich, Sony and athletes such as Shaun White make up to $8-million annually in sponsorship deals.

The X Games are so popular, ESPN has announced plans to expand from two annual events to six, three summer and three winter. Bids from potential host cities have been flooding in, including one from Whistler B.C., which sees the X Games as a complement to the 2010 Olympics. Meanwhile rival network NBC has started a competing series called Dew Tour with PepsiCo and the Olympics have taken up some X Games sports, including Burke’s specialty halfpipe skiing, which will be in the 2014 Games in Sochi.

The X Games “have gone viral,” says Lee Berke, who runs consulting firm LHB Sports, Entertainment & Media Inc. in New York. “It’s very grassroots in its appeal.” Berke added that the X Games have won over major sponsors because the viewing audience is so young, largely 18-34, which means many have yet to form brand loyalties.

But at the root of it all is the question: why? Why do athletes gamble with their lives by doing something so inherently dangerous? Like flying upside down off a 22-foot snow wall or skiing from ridiculous heights?

Asit Rathod has a wonderful life. He’s single, active, works at a sales job in Portland, Ore. But as often as he can, he climbs to the top of Mt. Hood and skis off a cliff with a parachute on his back. He’s done it many times and is now eyeing bigger verticals – Mount Kilimanjaro and Mount Everest.

Ask him why he does it and Rathod’s passion runs wild.

“People always say, ‘Why do you feel the need to risk your life?’ It’s about the power of adventure. In day-to-day life, adventure has been ripped from us in the way we drive, the way we eat. You get to that place where you have to have that adventure,” he said. “The risk is always the excitement.”

Rathod was a good friend of Shane McConkey, who died in 2009 when he skied off a cliff in Italy and his chute failed to open. Over the past four years, Rathod has lost “six, seven good friends” to extreme-sport accidents yet he has no plans to take up something with a safer track record.

“You remember their spirit. You remember their smile,” he said of his fallen comrades. “If anything, it gives you more inspiration to do what you’re doing. It’s like Nietzsche said, ‘The secret to reaping the greatest fruitfulness and the greatest enjoyment from life is to live dangerously.’”

Jacques Rogge, the president of the International Olympic Committee, was saddened by the news of Burke’s death but insisted freestyle skiing is no more dangerous than any other winter sport. “There are always risks attached to sport,” he stated.

Mitigating those risks is the relentless challenge. The International Ski Federation is presently examining how to equip downhill skiers with air bags to protect them during high-speed spills. FIS has been working with Dainese, the Italian company that makes protection for mountain bikers and motorcyclists. Canadian downhillers Erik Guay and Jan Hudec have been involved in the testing. Three years into the project, FIS is hoping to have a race suit fully ready for the end of this year.

Not so high tech, yet just as important, is the way young athletes are trained for their sport. Alpine Canada is holding a series of speed skills camps to instruct young racers on how to ski safely. At Calgary’s Canada Olympic Park, there are plans to expand on an acrobatics room with trampolines and foam pits for budding freestylers. The kids, ages 9 to 14, practise there first before graduating to jumping off a ramp and landing in an air bad. Eventually, after hundreds of practice jumps, they move to the snow and begin in moderation.

“What we’re doing is hiring top coaches to train top athletes,” said Daniel Lefebvre, COP’s director of education/sport development. “You have to build their confidence.”

Shouldice, who recovered from both of his bad crashes but is currently sidelined with a concussion, endorses all of that – solid training and coaching. He also believes Burke’s death, whole tragic, will not adversely affect freestyle skiing.

“I don’t think this is going to change anyone’s opinion of freestyle,” he said. “Yes, there are risks. There are risks driving to work every day, Look at the number of people in freestyle and this is our first death. A lot of sports can’t say that.”

Article from the Globe and Mail


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Med Students will Receive Training for Treatment of PTSD in Veterans

posted by SK Brain Injury    |   January 19, 2012 10:12

 Academic institutions are partnering with a military support initiative led by the Obama administration to improve care for post-traumatic stress disorder, depression and traumatic brain injury.

First lady Michelle Obama announced that 130 medical education programs have agreed to participate in a program ensuring that physicians are trained to recognize and treat combat PTSD and TBI. Obama spoke about the initiative Jan. 11 at Virginia Commonwealth University School of Medicine in Richmond, one of the participating schools.

"By directing some of our brightest minds, our most cutting-edge research and our finest teaching institutions toward our military families, they're ensuring that those who have served our country receive the first-rate care that they have earned," she said.

The effort is part of the administration's Joining Forces initiative, which coordinates support from different sectors of the economy for service members. Joining Forces Executive Director Brad Cooper said the majority of military personnel return from war without injury, but one in five soldiers are impacted by PTSD. A 2008 report by the Rand Corp. estimated that about 300,000 service members had developed PTSD or major depression stemming from deployments to Afghanistan or Iraq.

Many medical colleges offer training for treating PTSD, but most do not, Cooper said. Schools agreeing to join the Joining Forces program have pledged to ensure that future physicians are taught the clinical challenges of caring for veterans and other service members, many of whom are in their 20s and 30s and will need treatment over their lifetimes.

"The commitment is going to help train the nation's future physicians on military cultural issues, including PTSD and TBI as a focus," Cooper said. "They will also develop new research and clinical trials so that we can better understand and treat these conditions -- and share information and best practices through a robust collaborative forum that previously did not exist."

Participating schools will have access to websites that allow them to share educational resources, said John E. Prescott, MD, chief academic officer with the Assn. of American Medical Colleges. The initiative also will survey medical schools to understand the current scope of PTSD and TBI research and advances in clinical careThe American Medical Association applauded the Joining Forces initiative for its work, said AMA President-elect Jeremy A. Lazarus, MD. "By highlighting these issues to physicians, encouraging continuing medical education activities and working with Joining Forces initiative partners, the AMA is committed to ensuring that service members and their families receive the quality care they deserve."

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