The Crash Reel

The Brain Injury Alliance of Oregon has asked me to forward the event below to my readers.  I have participated and taught in programs for this group previously and recommend this event.


The Crash Reel

Crash Reel: The Ride of a Lifetime


Crash Reel:  The Ride of a Lifetime
The Kevin Pearce Story

Training to compete at the 2010 Winter Olympics, Kevin suffered severe traumatic brain injury from a 2009 accident in Park City, Utah. His tight-knit Vermont family flew to his side, and together they began an intensive process of trying to rehabilitate him and help him rebuild his permanently damaged life. Kevin's determination and the tireless support of family and friends kept him focused on recovery. But when he insisted he wanted to return to the sport he loved, his family objected. As an elite athlete, Kevin was a professional risk taker, but as a brain-injury survivor, his skills were now impaired, and even a small blow to the head could kill him.


Limited number of tickets  can be purchased here.

April 26th, 7 pm

5th Ave Cinema

510 SW Hall St.

Portland, OR 97201

"It's all part of the perplexing question: what if the thing you love the most may kill you?"


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Brain Injury Alliance of Oregon


Sleep-Wake Cycles and Alzheimer's

Being awake at night and dozing during the day can be a distressing early symptom of Alzheimer's disease, but how the disease disrupts our biological clocks to cause these symptoms has remained elusive.

Now, scientists from Cambridge have discovered that in fruit flies with Alzheimer's the biological clock is still ticking but has become uncoupled from the sleep-wake cycle it usually regulates. The findings - published in Disease Models & Mechanisms - could help develop more effective ways to improve sleep patterns in people with the disease.

People with Alzheimer's often have poor biological rhythms, something that is a burden for both patients and their carers. Periods of sleep become shorter and more fragmented, resulting in periods of wakefulness at night and snoozing during the day. They can also become restless and agitated in the late afternoon and early evening, something known as 'sundowning'.

Biological clocks go hand in hand with life, and are found in everything from single celled organisms to fruit flies and humans. They are vital because they allow organisms to synchronise their biology to the day-night changes in their environments.

Blast Injury

Blasts may cause brain injury even without symptoms: Veteran study

Veterans exposed to explosions who do not report symptoms of traumatic brain injury (TBI) may still have damage to the brain's white matter comparable to veterans with TBI, according to researchers. Veterans of recent military conflicts in Iraq and Afghanistan often have a history of exposure to explosive forces from bombs, grenades and other devices, although relatively little is known about whether this injures the brain. However, evidence is building – particularly among professional athletes – that subconcussive events have an effect on the brain.

Craig Hospital Award

Craig Hospital again made the News.

Craig Hospital in Denver, Colorado is a world-renowned rehabilitation hospital that exclusively specializes in the neuro-rehabilitation and research of patients with spinal cord injury (SCI) and traumatic brain injury (TBI). Craig is a not-for-profit, free-standing, national center of excellence that has treated nearly 30,000 patients with SCI and TBI since 1956.

Craig Hospital has received the American Nursing Association's top honor in the rehabilitation hospital category for the third time in four years. Craig is among six hospitals that received the NDNQI Award for Outstanding Nursing Quality® at the American Nurses Association's (ANA) Nursing Quality Conference™ Wednesday, February 5, in Phoenix, AZ. The award winners participated in ANA's National Database of Nursing Quality Indicators® (NDNQI®), the nation's most comprehensive database of nursing performance measures.


Brain Injury Association of America Legislative Update

I am forwarding this on to you from the Brain Injury Association of America:

President's FY 2015 Budget Released Today, March 4, 2014, President Obama released his Fiscal Year (FY) 2015 budget, which focuses on job creation initiatives, bolstering education, and research. After analyzing the President's proposed FY 2015 budget, BIAA is pleased to report that programs authorized by the TBI Act are slated to receive funding that is level with FY 2013 appropriations measure and the FY 2014 continuing resolution. In the current fiscal climate this is good news for TBI advocates. This indicates TBI funding is not on the chopping block as policymakers seek to cut a $1.5 trillion in federal spending. The President's budget would fund the Federal TBI Program at $9 million in FY2015, allowing the Health Resources and Services Administration (HRSA) to administer grants to 20 states to improve systems coordination for individuals with brain injury as well as make grants to all protection and advocacy organizations. The budget also proposes just under $7 million for the Centers for Disease Control and Prevention (CDC) to collect data, link military and civilian populations with TBI services, increase public awareness, and conduct public health research. The President's budget recommends increasing funds for the National Institute on Disability and Rehabilitation Research (NIDRR) of the U.S. Department of Education. In FY 2013, NIDRR was funded at $104 million with FY 2015 funding to be increased to $108 million. NIDRR administers grants to the TBI Model Systems, which is a collection of research centers located across the U.S. that conduct disability and rehabilitation research. The TBI Model Systems are the only source of non-proprietary longitudinal data on what happens to people with brain injury. The TBI Model Systems are a key source of evidence-based medicine, and serve as a "proving ground" for future researchers. BIAA will continue to work to ensure that legislators understand the importance of these programs and how they affect the 2.4 million people with brain injury in the U.S. Grassroots advocates should be ready for appropriations alerts to drive home this vital message this spring.

North American Brain Injury Society

The North American Brain Injury Society is pleased to announce that the 27th Annual Conference on Legal Issues in Brain Injury will be held March 20-22, 2014, in conjunction with the International Brain Injury Association's Tenth World Congress on Brain Injury. The conference will take place at the Hyatt Embarcadero Hotel, San Francisco, California. This conference has a long history of educating participants in various fields about Brain Injury issues. The speakers are of the highest caliber in the country. Click on NABIS to learn more.

Mood Improves Brain Injury Rehabilitation

Mayo Clinic researchers found that improvement of mood over the course of post-acute brain rehabilitation is associated with increased participation in day-to-day activities, independent living, and ability to work after rehabilitation is complete.

This is consistent with findings suggesting that depression and mood disorders can manifest after traumatic or acquired brain injury.  The consequences of brain injury often include depression, a pessimistic and even

Each year, millions of patients are diagnosed with traumatic or acquired brain injuries, such as concussion, strokes and brain tumors, many of whom go on to have persistent symptoms. For these patients, brain rehabilitation is an important part of their recovery.

The study examined data on patients who have gone through treatment at Mayo's Brain Rehabilitation Center, receiving therapies from a team of providers which are customized to the specific needs of each individual. Mood was assessed at the beginning and end of treatment, and researchers found that improved mood was associated with improved brain rehabilitations outcomes. The findings were presented during the American Congress of Rehabilitation Medicine Annual Conference.

12th Annual Northwest Brain Injury Conference

12th Pacific Northwest Regional Brain Injury Conference 2014
Hosted by BIAOR and BIAWA

 Registration is now open for the 12th Annual Pacific Northwest Regional Conference 2014! Early bird pricing (available until March 1) for Professional members will be $475 for all three days, $100 for Thursday, March 13, only (8.5 CEUs), $350 for Friday and Saturday (15.5 CEUs).

Who should attend?

  • Attorney's - Win More Cases-Help More Clients
  • Medical Professionals - Increase your understanding and strengthen you skills dealing with individuals with brain injury
  • Case Managers - Learn about the newest and latest resources while increasing your understanding and strengthening you skills dealing with individuals with brain injury
  • Vocational Rehabilitation Counselors, Special Education Teachers, Youth Transition specialists- learn strategies in dealing with consumers and students that have varying degrees of difficulty, increasing positive outcomes
  • Adult Foster Home Providers, Caregivers, Family Members - learning strategies in dealing with difficult behaviors helping survivors reach the highest level of functioning possible


When I come Home from the Hospital will focus on effective ways working with individuals with brain injury and best practices being used. This is an interactive day long workshop that includes lecture, demonstrations and a round table question and answer session with the experts--bring your questions. Intended audience are case managers, trauma nurses, foster care providers, nursing home staff, family caregivers and all other interested attendees.

Keynote Speakers will be:
Life After Concussion: Dr. James Chesnutt, MD and Jenna Sneva

Oregon Governor's Task Force On Traumatic Brain Injury - an interactive presentation round table discussion with the Oregon TBI Task Force and attendees

Concussion Laws in the United States - Are We Making a Difference - Richard Adler, JD

Journey for Thought - 4200 Miles Later
Jeff Rawley and Chris Hart will discuss their 4200 bike ride across the country to raise awareness for brain injury

Throughout the three days, we will highlighting The Talent Within Us featuring the works of survivors as they display the arts and crafts that they are doing including painting, quilting, and handcraft's, many for sale, with interactive demonstrations over working lunches.

Register Now! 

Alzheimer's Origin

Sustaining Traumatic Brain Injury has long been held to increase the potential for Alzheimer's earlier in life.

Using high-resolution functional MRI (fMRI) imaging in patients with Alzheimer's disease and in mouse models of the disease, Columbia University Medical Center (CUMC) researchers have clarified three fundamental issues about Alzheimer's:

1.  Where it starts,

2.  Why it starts there,

3.  and How it spreads.

96 adults were followed for an average of 3.5 years, at which time 12 individuals were found to have progressed to mild Alzheimer's disease compared with 84 who did not. We now may be able to detect Alzheimer's at its earliest preclinical stage, when the disease might be more treatable and before it spreads to other brain regions.

New research suggests that a daily dose of vitamin E may help to slow functional decline for patients with mild to moderate Alzheimer's disease and may help reduce the amount of care these patients need. This is according to a study published in JAMA.

Vitamin E is defined as a group of eight fat-soluble compounds. These compounds include a mix of tocopherols and tocotrienols.

The vitamin is naturally found in many foods, including eggs, fortified cereals, fruit, green leafy vegetables, meat, nuts, poultry and vegetable oils. It can also be taken as a supplement.

According to the research teamat the Minneapolis VA Health Care System, previous studies have looked at the use of alpha tocopherol - a form of vitamin E that also acts as an antioxidant - in patients with severe Alzheimer's disease.

These studies have shown that the vitamin was effective in slowing progression of moderately severe Alzheimer's disease. 

The researchers point out that functional decline as a result of Alzheimer's disease is increasingly recognized as having a significant impact on a patient quality of life, as well as putting a strain on social and economic costs. 

Pavlovian Conditioning and Memory

Researchers at the University of Houston (UH) have taken a significant step forward in unraveling the mechanisms of Pavlovian conditioning. Their work will help them understand how memories form and, ultimately, provide better treatments to improve memory in all ages.

Wikipedia describes Ivan Pavlov as a Russian physiologist known primarily for his work in Classical Conditioning.   Pavlov abandoned his religious career and decided to devote his life to science. In 1870 he enrolled in the physics and mathematics faculty at the University of Saint Petersburg to take the course in natural science. Ivan Pavlov devoted his life to the study of physiology and sciences, making several remarkable discoveries and ideas that were passed on from generation to generation. He won the Nobel Prize for Physiology or Medicine in 1904.

He had come to learn this concept of conditioned reflex when examining the rates of salivations among dogs. Pavlov had learned then when a buzzer or metronome was sounded in subsequent time with food being presented to the dog in consecutive sequences, the dog will initially salivate when the food is presented. The dog will later come to associate the sound with the presentation of the food and salivate upon the presentation of that stimulus.

Study findings are published in Current Biology, a scientific bimonthly journal published by Cell Press.  Gregg Roman, an associate professor of biology and biochemistry at UH, and Shixing Zhang, his postdoctoral associate, set about to unravel some of these mysteries by studying the brains of fruit flies (Drosophila). Within the fly brain, Roman says, there are nerve cells that play a role in olfactory learning and memory. Olfactory learning, he says, is an example of classical conditioning first described by Pavlov in his experiment with dogs. In their study, the flies were trained to associate a weak electric shock with an odor. After training, the flies avoided that odor.  

The pair says all their experience to date suggests the molecules and logic will translate to most animals, including humans, leading to a more complete understanding of how memories form in humans, both at the level of molecules and through the activity of neural circuits.

Dementia News!

It's rare to hear good news about dementia. But that's what a New England Journal of Medicine Perspective article reports. The article discusses several recent studies that show how age-adjusted rates in aging populations have declined for people born later in the last century, particularly in those older people most likely to develop dementia and Alzheimer's disease.

Dementia and Alzheimer's are dependent on life style the recent study suggests.

In 2008, Drs. Langa and Larson reported one of the first studies suggesting a decline in U.S. dementia rates, using information from the U.S. Health and Retirement Study. They found that the decline tracked with education, income, and improvements in health care and lifestyle. Since then, several studies in Europe have confirmed this trend - and the reasons behind it.

"We're very encouraged to see a growing number of studies from around the world that suggest that the risk of dementia may be falling due to rising levels of education and better prevention and treatment of key cardiovascular risk factors such as high blood pressure and cholesterol," Dr. Langa said. He added that it will be very important to continue to follow these trends in the population given the wide-ranging impact of dementia on patients, families, and the health care system.

Concussion Symptoms Fade But Brain Still Injured

The American Academy of Neurology (AAN) published findings this month indicating that Brain Injury continues even after concussion symptoms fade.  After a mild concussion, special brain scans show evidence of brain abnormalities four months later, when symptoms from the concussion have mostly dissipated.  The study was supported by the National Institutes of Health.

The American Academy of Neurology, an association of more than 26,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

Study author Andrew R. Mayer, PhD, of the Mind Research Network and University of New Mexico School of Medicine in Albuquerque said standard brain scans such as CT or MRI would not pick up on these subtle changes in the brain. “Unfortunately, this can lead to the common misperception that any persistent symptoms are psychological.” 



Do Bone Fractures Reduce Life Expectancy?

A study to determine the likelihood of reduced life expectancy resulting after a bone fractured has been published in the Journal of Clinical Endocrinology and Metabolism.

After trauma, a person may experience a shortened life expectancy if they fail to get proper treatment.  Normal life expectancy can be restored and maintained with proper treatment.

It is well known that hip and vertebral fractures increase the risk of premature death. Until now,  little has been known about the clinical impact of non-hip, non-vertebral fractures - so new Australian research showing that they may also increase the risk of death will better inform treatment.

Non-hip, non-vertebral fractures make up 50% of all osteoporotic fractures, and while they are less severe than hip and vertebral fractures, they are potentially very serious, and should be treated with bone-strengthening drugs to reduce the risk of further fracture.

The following findings were made:

  1. All fractures are serious, some more serious than others, and most have the potential to reduce life expectancy,
  2. Although we use the blanket terms 'hip and vertebral fractures' and 'non-hip, non-vertebral fractures' there is even a sliding scale of severity depending on specific fracture type,
  3. Hip fractures have much poorer outcomes and higher mortality, for example, than vertebral fractures,
  4. 'Proximal fractures', or those close to the body, such as humerus, rib or pelvic fractures, can be as serious as vertebral fractures, and have the potential to shorten life. 'Distal fractures', such as those in the wrist or ankle, do not in themselves shorten life, although they should be taken seriously because they double the risk of re-fracture,
  5. For people over 75, the risk of having a subsequent fracture is the same, no matter what the initial fracture type. This is important to know, because the second fracture could be a hip or vertebral fracture, even though the initial fracture is not.

Minor or Mild Traumatic Brain Injury a Silent Epidemic

 Minor or Mild Traumatic Brain Injury has resulted in what scientists are calling a Silent Epidemic.

According to a literature review appearing in the October 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), falls and motor vehicle accidents are responsible for most cases of mTBI and also are a common cause of bone and joint injuries. Musculoskeletal injuries are often seen concurrently with some studies estimating that 50 percent of patients with orthopaedic injuries also sustain a Mild Traumatic Brain Injury frequently denoted as "mTBI."

To repeat the long espoused comment that a minor brain injury is not the same as a minor injury.  I often say that ANY injury to the brain has the potential of being serious.  Serious in terms of what may result in a person's cognitive ability, personality and way of life.

 A Silent Epidemic: mTBI by the Numbers

  • The Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control declared mTBI a major public health issue and a silent epidemic.
  • Patients with multisystem trauma and mTBI are almost twice as likely as those with multisystem trauma alone to have persistent cognitive impairment and to report symptoms of depression, anxiety, and posttraumatic stress disorder.
  • Patients with mTBI and lower extremity injuries are three times more likely to experience cognitive and behavioral difficulties at one year post-injury than those who sustain only lower extremity trauma.
  • When symptoms last for more than three months, a patient is said to have post-concussion syndrome (PCS), a disorder that can be associated with substantial financial, social, and emotional challenges.
  • Males from newborn to 4 years old are among the population most prone to suffering mTBI and have the highest rate of TBI-related emergency department visits.
  • Males are more likely than females in all age groups to sustain mTBI.

Orthopaedic surgeons can play a crucial role in diagnosing mTBI because, in addition to providing long-term care for the traumatic musculoskeletal injuries, they can ensure that patients are appropriately referred to those with expertise in managing mTBI.


Depression in Children with Traumatic Brain Injury

 Using data from the 2007 National Survey of Children's Health, researchers identified more than 2,000 children with brain injuries, reflecting the national child brain injury rate of 1.9 percent in 2007; and 3,112 children with diagnosed depression, mirroring the 3.7 percent national child depression rate that year. Compared to other children, 15 percent of those with brain injuries or concussions were diagnosed as depressed -- a 4.9 fold increase in the odds of diagnosed depression.

 Depression is two times more likely in children with brain injury or concussion.  This comes from an abstract written by author Matthew C. Wylie, MD in "Depression in Children Diagnosed with Brain Injury or Concussion."

This study, the largest of its kind, may enable better prognostication for brain-injured children and facilitate identification of those at high risk of depression