Brain and Spine Injury Lawyer & Attorney : Titolo Law Firm : Las Vegas, Nevada

Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis. Possible causes of widespread (diffuse) brain damage include prolonged hypoxia (shortage of oxygen), poisoning by teratogens (including alcohol), infection, and neurological illness. Chemotherapy can cause brain damage to the neural stem cells and oligodendrocyte cells that produce myelin. Common causes of focal or localized brain damage are physical trauma (traumatic brain injury), stroke, aneurysm, surgery, or neurological illness.

The extent and effect of brain injury is often assessed by the use of neurological examination, neuroimaging, and neuropsychological assessment.

Brain injury does not necessarily result in long-term impairment or disability, although the location and extent of damage both have a significant effect on the likely outcome. In serious cases of brain injury, the result can be permanent disability, including neurocognitive deficits, delusions (often specifically monothematic delusions), speech or movement problems, and mental handicap. There may also be personality changes. Severe brain damage may result in persistent vegetative state, coma, or death.

Various professions may be involved in the medical care and rehabilitation of someone who suffers impairment after brain damage. Neurologists, neurosurgeons, and physiatrists are physicians who specialise in treating brain injury. Neuropsychologists (especially clinical neuropsychologists) are psychologists who specialise in understanding the effects of brain injury and may be involved in assessing the extent of brain damage or creating rehabilitation programmes. Occupational therapists may be involved in running rehabilitation programs to help restore lost function or help re-learn essential skills.

It is a common misconception that brain damage sustained during childhood has a better chance of successful recovery than similar injury acquired in adult life. It is contested that in recent studies, severe brain damage inflicted upon children can be alleviated by the interaction of nicotinamide repropagation in nerve cells. In fact, the consequences of childhood injury may simply be more difficult to detect in the short term. This is because different cortical areas mature at different stages, with some major cell populations and their corresponding cognitive faculties remaining unrefined until early adulthood. In the case of a child with frontal brain injury, for example, the impact of the damage may be undetectable until that child fails to develop normal executive functions in his or her late teens and early twenties.

The effects of impairment or disability resulting from brain injury may be treated by a number of methods, including medication, psychotherapy, neuropsychological rehabilitation, snoezelen, surgery, or physical implants such as deep brain stimulation.

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Dr. Elizabeth Zelinski of the University of Southern California is making a presentation today at the annual meeting of the Gerontological Society of America.  She is revealing initial data from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training study (IMPACT).  This study is the largest  for aging and cognitive training.

The right kind of brain exercise enhances memory and other cognitive abilities of older adults.  To read the entire article click here.

The website Posit Science: Your Brain will Thank You is a great resource to improve you cognitive ability.  The Brain Fitness Program is a series of computer-based exercises that are scientifically proven to improve important brain functions.

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Leading neuroscientists and practitioners debunk common myths related to health and fitness of the brain in a new whitepaper from SharpBrains, Inc. The 11 experts help illuminate the growing research on the role of "brain exercise" for brain fitness, one of the promising areas being discussed this week during the 37th annual meeting of the Society for Neuroscience in San Diego.

Health and Medicine-related myths

- Myth 1: It's all in our genes. Reality: A big component of our lifelong brain health and development depends on what we do with our brains. Our own actions, not only our genes, influence our lives to a large extent.

- Myth 2: The field of Brain Fitness is too new to be credible. Reality: The field rests on solid foundations dating back more than a decade - what is new is the number and range of tools that are now starting to be available for healthy individuals.

- Myth 3: Medication is and will remain the only evidence-based intervention for problems such as ADD/ ADHD for many years to come. Reality: Cognitive training programs are starting to show value as complements to drug-based interventions.

Education-related myths

- Myth 4: We need to buy expensive computer-based programs to improve our brains. Reality: Every time we learn a new skill, concept or fact, we change the physical composition of our brains. Lifelong learning means lifelong neuroplasticity.

- Myth 5: Schools should just focus on basic skills like Reading and Math. Reality: "Mental muscles," such as working memory, are fundamental to academic performance and are currently overlooked by the school system.

Corporate Training myths

- Myth 6: On-the-job training is the only way to train one's mind. Reality: Computer-based programs can be more effective at developing specific "mental muscles."

- Myth 7: Brain exercise is only for seniors. And, only about memory. Reality: People of all ages can benefit from a variety of regular brain exercises. For active professionals, managing stress and emotions is often a good first step.

- Myth 8: This all sounds too soft to be of real value to business people. Reality: There is nothing soft about the hard science-based training of specific cognitive and emotional skills.

Gaming-related myths

- Myth 9: Videogames are always a waste of time. Reality: Scientifically designed, computer-based programs can be a good vehicle for training specific skills. For example, it has been shown that short term memory can be expanded by such programs.

- Myth 10: This means kids will spend more time playing videogames. Reality: In Japan - the world's earliest adopter of brain-related videogames - overall home videogame sales have declined, with children playing less over time. Interestingly, adults in Japan have started to play brain-related videogames more. 

 For more information about health and fitness and the brain, visit www.SharpBrains.com.

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Researchers Try to Predict Epilepsy

WASHINGTON (AP) -- Survivors of traumatic brain injuries - from car-crash victims to soldiers wounded in Iraq - face an extra hurdle as they recover: Thousands of them will develop epilepsy months or years later. The risk is especially high for certain kinds of war injuries. Studies of Vietnam veterans suggest up to 50 percent, says Dr. Nancy Temkin of the University of Washington.

Major new research is beginning into ways to predict exactly who is most at risk and how to protect their vulnerable brains.

Among the efforts: pilot studies to see if the newer seizure-treating drugs Topamax or Keppra might actually prevent epilepsy if they're taken immediately after a serious brain injury.
"It is among the most frustrating things in medicine to know that someone's at risk ... and be unable to do anything about it," says Dr. Marc Dichter of the University of Pennsylvania, who is leading the Topamax study and pushing for better recognition of such patients.

Adding to their struggle: Epilepsy may not begin with the classic jerking seizures, but instead with memory loss, attention problems or other more subtle symptoms that doctors can mistakenly attribute to the original brain injury, post-traumatic stress or some other factor.

 
Almost 3 million Americans have epilepsy, a condition in which the brain essentially suffers periodic electrical storms. When its circuits misfire fast enough, a seizure results.
Epilepsy has multiple causes. Some people are born with it.

But about 5 percent of the nation's epilepsy was caused by traumatic brain injury, or TBI. What's the risk? Roughly 25 percent of survivors of moderate to severe brain injury will develop epilepsy. Even more, perhaps, for certain types of war injuries.

Injuries that cause bleeding inside the brain are the riskiest.

The population at risk is huge: Some 1.4 million children and adults suffer serious brain injuries every year from car or bike crashes, falls, gunshot wounds and other trauma.

After the initial injury, inflammation and treatment comes a "silent period" during which survivors work to recover. It can last months or even years before epilepsy appears.

 
"This silent period is not really silent," Dr. Shlomo Shinnar of the Albert Einstein College of Medicine told a meeting of epilepsy specialists at the National Institutes of Health last week.
Instead, as the damaged brain tries to rewire itself - a crucial process called plasticity - misfiring circuitry can form. Injured neurons can make new connections in wrong places, or overly excitable connections. Even the brain's genes change the way they work after head injury.

"You need the plasticity for recovery. You don't want to stop it. You just want to structure it in a way that it aids recovery without causing seizures," Temkin explains.

 
It's not clear yet how to do that, so scientists instead are testing what's available - seizure-controlling drugs - as possible epilepsy preventers. Three old medications have failed. New pilot studies funded by the NIH and Defense Department are checking Topamax and Keppra, which work differently from older competitors.

 
"It's a bit of a shot in the dark," acknowledges Dr. Pavel Klein, who is running the Keppra study at Washington Hospital Center and Children's National Medical Center in the nation's capitol.
But there are some hints that these newer drugs might work, perhaps by inhibiting cell-harming chemicals wrought by post-injury inflammation, he says.

 
Each study is enrolling about 90 patients, a first step to ensure the drugs won't harm overall recovery before larger trials begin. Participants get the drug within hours of arriving at the emergency room, and take it for one to three months. Klein has treated 60 patients so far with no serious side effects; Dichter's study at Penn begins enrolling soon.

Until some protection is found, Dichter wants a bigger effort at warning about the epilepsy risk so that patients can recognize subtle symptoms. At his urging, the American Epilepsy Society is creating a task force to target brain-injured soldiers, work that Dichter says may eventually translate to the far bigger population of injured civilians.

Consider Denise Pease, an assistant comptroller for New York City. Months after what was initially deemed a minor head injury in a 1995 taxi crash, she began experiencing lost periods of time, increasing confusion and cognitive problems.

"This woman who dealt with the titans of industry ... was unable to make change at the corner store," Pease told the NIH meeting.

Only when a nephew witnessed a muscle-jerking seizure well over a year later did she get the right diagnosis and begin her recovery. Today, after years of trying different medications, she has good epilepsy control, and warns that "my experience ... is not unique."
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Money Magazine (September 2007)[i] recently covered the topic of how the brain controls investment decisions.   A new term, Neuroeconomics, was introduced as the “hybrid of neuroscience, economics and psychology.” Neuroeconomics is making remarkable discoveries about how the brain evaluates rewards, sizes up risks, and calculates probabilities.

Our brains are wired to improve the odds of survival. We crave what looks rewarding and avoid what looks risky.   Similar to Malcolm Gladwell’s, Blink: the Power of Thinking without Thinking, emotions like hope, surprise, regret, fear and greed – as a matter of biology – affect our decision making.

Neuroscientist, Brian Knutson, at Stanford University, concluded that the brain fires neurons more when it anticipates reward then when it gets it. Dr. Knutson’s mentor, Jaak Panskepp of Bowling Green State University in Ohio, calls that function “the seeking system.”

Paul Slovic, a psychologist at the University of Oregon, says our anticipation wiring acts as a “beacon of incentive” that helps us pursue rewards that require patience and commitment. Hence we work hard for imagined wealth in the future and forego smaller gains in our present.

To test whether memory improves when anticipating financial rewards researchers used fMRI to view brain activity. It was revealed that looking at potentially rewarding pictures set off more intense activity in the hippocampus. The hippocampus is the part of the brain that houses long term memory. Emrah Duzel, neurologist, says “The anticipation of reward is more important for memory formation then is the receipt of reward.”

The amygdala is the reflexive part of the brain that acts like an alarm system. Neuroscientist, Gregory Berns, led a study of brain activity when following what others did versus going it alone. When people went against the consensus they showed heightened activity. Berns called it “the emotional load associated with standing up for one’s belief.” The same areas of the brain that trigger physical pain are activated by social isolation. In other words, you go along with others because it hurts not to.

Neurologists, Antonio Damasio and Antoine Bechara, conclude from research tests on persons with damaged amygdalas that decisions are driven by fear even though they do register in the thinking part of the brain and the mind has no idea of being afraid. Just like Gladwell’s Blink: the Power of Thinking without Thinking reveals, Damasio finds that without fear the human brain keeps trying to beat the odds regardless of logic. “The process of deciding advantageously is not just logical but also emotional.”

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The New York Times published a great article about the dangers associated with not recognizing the signs and warnings associated with Football injury.  Too often sporting goals prompt those who could make a difference dealing with injuries to fail players and themselves.  The issues of multiple impacts and multiple concussions seen in many contact sports like football and boxing are getting more and more attention.

The National Football League has recently faced questions about its handling of concussions after four former players were found to have significant brain damage as early as their mid-30s. But teenagers are more susceptible to immediate harm from such injuries because, studies show, their brain tissue is less developed than adults’ and more easily damaged. High school players also typically receive less capable medical care, or none at all.

At least 50 high school or younger football players in more than 20 states since 1997 have been killed or have sustained serious head injuries on the field, according to research by The New York Times.

Read the full article click here

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The Epidemic of Brain Injury care is far reaching. A recent study shows that brain injury survivors are not cared for. In terms of representing these people’s legal interests, convincing insurance companies and defense lawyers of this reality is imposing. Additionally, the future for these people, as found in the study, makes them victims again.

The report for the State of Virginia reveals what is true in many, if not all states:  veterans returning from the war will face difficult hurdles receiving care for brain injuries.  To read more about the situation click here.

Here are a few of the findings of the Joint Legislative Audit and Review Commission study:

The numbers: Up to 6,650 people with brain injuries are in nursing homes, and about 600 others are in state hospitals or in long-term care facilities, including psychiatric units.

Available care: Outside of institutionalization, only about 20 beds exist in Virginia to provide the intensive and costly treatment needed for tens of thousands of brain-injury survivors with complex neurobehavioral problems that can result in violent outbursts and other unmanageable behavior. "There is virtually no system of care in the community for people with behavioral problems who do not have the financial resources to pay for private care."

Tragic consequences: Brain-injured people often become homeless after their caregivers die; many end up in jails or seek divorce to qualify for care.

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The Tragedy of Brain Injury in the Decade of the Brain

The statistics of brain injury are staggering: 700,000 brain injuries each year in the United States; 100,000 deaths per year; and 70,000 - 90,000 people permanently disabled as a result of brain injury. Most serious automobile accidents involve a brain injury. Many of these injuries are serious, but many also form "mild"  and "moderate" categories. Victims experience significant personality changes, debilitating cognitive deficits and serious physical and social problems, yet they are often seen as "normal" by some in the medical profession. One author called them the "walking wounded." Their plight is often unnoticed and their needs are not served. It is truly "a silent epidemic."

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