Mild Traumatic Brain Injury-Twitter to Las Vegas

I have seen the following article on Twitter all day.  I finally decided it was worth posting.  This is the source of the Twitter appearing as "Mild Traumatic Brain Injury, Not So Mild After All."  See Science Daily.  It appears to be a hot blog topic.

Douglas Smith, MD, director of the Center for Brain Injury and Repair and professor of Neurosurgery at the University of Pennsylvania School of Medicine, will present information on the molecular mechanism at play in mild TBI (mTBI), commonly called concussions. Although mTBI affects over 1 million people each year in the United States, it is generally ignored as a major health issue. However, this 'mild' form of injury induces persisting neurological and cognitive problems in many of these patients, exacting an enormous emotional and financial toll on society.

Despite the prevalence and impact of mTBI, little is known about how mTBI affect nerve cells and connections in the brain, and therefore clinical outcomes after injury. Smith and colleagues have begun to amass data from human and animal studies on mTBI at 2-4 days after injury using advanced neuroimaging techniques. They have found distinct changes throughout the white matter in the brain. Also, protein markers of brain pathology were identified after mTBI in the blood of mTBI patients.

The team proposes a potential molecular mechanism to explain their findings. Specifically, they found that the stretching and disconnecting of nerve-cell axons after mTBI induces problems to the sodium channels found on the surface of neurons.

"This is not inconsequential," say Smith. "Indeed, the observation that brain pathology can be detected after a concussion calls for much more extensive efforts to prevent, diagnose, and treat mild traumatic brain injury."

PTSD and MTBI in Veterans Study

Pietrzak and colleagues published their study in the Journal of Nervous and Mental Disease (Posttraumatic Stress Disorder Mediates the Relationship Between Mild Traumatic Brain Injury and Health and Psychosocial Functioning in Veterans of Operations Enduring Freedom and Iraqi Freedom. Journal of Nervous and Mental Disease, 2009;197(10):748-753).

The study, from Yale University, evaluated whether posttraumatic stress disorder (PTSD) mediated the relationship between mild traumatic brain injury (MTBI) and general health ratings, psychosocial functioning, and perceived barriers to receiving mental healthcare 2 years following return from deployment in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF).

"Compared with respondents who screened negative for MTBI, respondents who screened positive for MTBI were younger, more likely to have PTSD, more likely to report fair/poor overall health and unmet medical and psychological needs, and scored higher on measures of psychosocial difficulties and perceived barriers to mental healthcare. Injuries involving loss of consciousness were associated with greater work-related difficulties and unmet psychological needs. PTSD mediated the relationship between MTBI and all of these outcomes." 

The researchers concluded: "These results underscore the importance of assessing PTSD in OEF/OIF veterans who screen positive for MTBI."


For additional information, contact R.H. Pietrzak, Yale University, School Medical, National Center PTSD, VA Connecticut Healthcare Systems, 950 Campbell Avenue 151E, West Haven, CT 06516, USA.
 

New Book on Mild Brain Injury

Here is a book worth checking out on Mild Brain Injury http://www.learningstore.org/we1181.html

Soldier with Mild TBI Dies of Drug Overdose

Indiana National Guard Sgt. Gerald "G.J." Cassidy, who served his country in Bosnia and Iraq, died alone and ignored in a barracks at Fort Knox from an accidental drug overdose. His fate left a legacy that has changed the lives of thousands of wounded soldiers, Army officials say.

Cassidy began experiencing migraine headaches after a roadside bomb exploded about 11 feet from his Humvee in Iraq in August 2006. With diagnoses of post traumatic stress disorder and mild traumatic brain injury.

One Fort Knox soldier told investigators, "The staff at the WTU did not keep accountability of soldiers and were not making any checks on the welfare of soldiers" with PTSD and brain injury.

On the day Cassidy died, his platoon sergeant reported him at formation when he actually hadn't seen him for two days.

After repeated calls from Melissa Cassidy after she had not heard from him in a couple of days, Sgt. Cassidy was found dead in his chair. A toxicology report from the Armed Forces Institute of Pathology ruled his death accidental, caused by "multi-drug toxicity," compounded by coronary artery disease.

Excerpted from Soldier's hospital death leads to changes as published in Associated Press.  Information from: The Courier-Journal, http://www.courier-journal.com