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

More attention has been paid to the mental health of American troops in Iraq and Afghanistan than in any previous war. Yet shame remains a significant barrier to military personnel and their families getting the psychiatric treatment they need, a report released Wednesday says.

Time Magazine reports today on the American Psychiatric Association's study that veterans are attaching a stigma to the psychiatric afftects of the war.  This is a function of educating the public and veterans about the reality of brain and mental injury.

The good news is nearly three-quarters of the 200 military men and women interviewed by the American Psychiatric Association (APA) said that it was very or somewhat easy for them to seek out mental health care. But 60% still feared that doing so could have negative consequences on their career. More than half reported they believe others would think less of them if they sought out counseling, and most surveyed said they have rarely or never spoken even to family and friends about mental health issues. These numbers show "there's still a long way to go towards reducing the stigma surrounding care," says APA board member Dr. Mary Helen Davis.

Click here to read the whole article.

• Print
• Comments
• Trackbacks

Blast Injuries and veteran brain damage is gaining attention as the war in Iraq continues.  Here is an article that addresses how the brain is injured in explosion events and how the brain may actually become increasing damaged as the trauma continues.

Blasts cause delayed brain trauma

Improvised explosive devices have killed at least 1,600 soldiers in Iraq since the United States invaded in 2003. Thanks to high-tech body armor, new helmets, and better resuscitation techniques, many more soldiers now survive blasts. But this has revealed a new problem: Blast exposure, especially repeated exposure, can cause brain damage so subtle that soldiers may not realize they've been wounded. Ibolja Cernak, director of the Biomedicine Business Area at the Applied Physics Laboratory, says that these mild brain injuries can lead to gradual neurodegeneration, similar to Alzheimer's disease.

Most experts acknowledge that explosions can injure the brain even when there is no direct blow to the head. The prevailing argument has been that waves of compressed air emanating from the blast shake the skull with enough force to strain or stretch the brain, not unlike what happens in a bad car crash. "It's like a turbo-charged whiplash," says Ross Bullock, a professor in the Department of Neurological Surgery at the University of Miami.

But Cernak's research suggests a different mechanism. She posits that energy from the explosion compresses the abdomen and chest, generating oscillating waves in large blood vessels such as the aorta. These waves, she says, then carry that energy, at the speed of sound in water, to the brain, where it induces slight physiological changes in brain structures — for instance, slowing a cell's metabolism or altering the permeability of its membrane — that can lead to delayed neuronal cell death. The effects can cascade over time. Symptoms such as balance problems and impaired speech may manifest months or years after the blast. Cernak calls this syndrome blast-induced neuro-trauma (BINT).

"If what she's saying is true," says Jeff Bazarian, a brain injury expert at the University of Rochester Medical Center in New York, "then how the brain gets injured by a blast is very different than how it gets injured in a car accident." Not everyone is convinced that Cernak is right, but if she is, her hypothesis has implications for body armor design. Armor currently used in the field contains hard plates that could, according to Cernak's hypothesis, concentrate the power of a blast and make neurological damage worse.

Cernak began her career at the Military Medical Academy in Belgrade. During the fighting that followed the collapse of Yugoslavia in the late 1980s, she was one of the first to study the neurological effects of blast injuries, sometimes collecting blood samples on the battlefield minutes after an explosion. Today most of her research takes place in the lab, where she replicates blast pressure waves using a shock tube, and studies their effect on rodents.
"I've been fighting since 1990 with the military medical community to convince them that BINT exists," Cernak says. "It is still a fight, but finally this problem is getting acknowledged." —Cassandra Willyard, A&S '07 (MA)

• Print
• Comments
• Trackbacks

Like so many areas of life in Iraq, the health care crisis is vast and complex, and there is no quick solution to improve conditions for doctors and patients.

According to figures from the Iraqi Health Ministry released earlier this year, 618 medical employees, including 132 doctors, as well as medics and other health care workers, have been killed nationwide since 2003, among the professionals from many fields caught up in Iraq's sectarian violence.

As the war continues its toll on human lives, the ripple affects of fear embrace other industries and compaound the problem.  There is a quandry, no doubt, that the anticpated benefits to a foreign nation's liberty (an American value with Christian borrowings) outweighs the current sacrafices being made.  The quandry being whether this is actually true or something American Government wants to be true.  Meanwhile, the difficulty (putting it mildly) of war's infestation.

Hundreds, possibly thousands, of other medical personnel are believed to have fled to Iraq's northern semiautonomous Kurdistan region and neighboring countries.

Even with the security gains of the past several months across Iraq, it is still dangerous for doctors and their families if they dare step out of heavily guarded hospital compounds.

Drugs supplies are so low that Iraqis hospitalized for illnesses as serious as cancer are asked to track down their own medicine.

• Print
• Comments
• Trackbacks

 Time magazine reports that Post Traumatic Stress Disorder risk is elevated in situations where a concussion occurs.  But not all concussions result in PTSD and not all PTSD requires concussion.

The article, along with the many others since the Afghanistan and Iraq wars, have brought the focus on brain injury and related issues into the public forum.  I hope this "awakening" will help educate lawyers, insurance companyies, Judges and juries about the very real "unseen" injury.

To read the article click here.

• Print
• Comments
• Trackbacks

I continue to follow the efforts made in diagnosing and treating brain injuries of war veterans.  The NY TImes reported a new study published in the New England Journal of Medicine.

About one in six combat troops returning from Iraq have suffered at least one concussion in the war, injuries that, while temporary, could heighten their risk of developing post-traumatic stress disorder, researchers are reporting.

The study, in The New England Journal of Medicine, is the military’s first large-scale effort to gauge the effect of mild head injuries — concussions, many of them from roadside blasts — that some experts worry may be causing a host of undiagnosed neurological deficiencies.

The new report found that soldiers who had concussions were more likely than those with other injuries to report a variety of physical and mental symptoms in their first months back home, including headaches, poor sleep and balance problems. But they were also at higher risk for the stress disorder, or PTSD, and that accounted for most of the difference in complaints, the researchers concluded.

Read more click here.

• Print
• Comments
• Trackbacks

Rep. Baron Hill, D-Ind. (9th CD), has issued the following news release:

"Americans were shocked to learn one year ago of a crisis in care for soldiers returning from Iraq and Afghanistan," Hill added. "America can do better, and this historic funding increase, paired with our Wounded Warriors Act reforms, puts us on the right track for America's veterans."

With the release of these funds, the 110th Congress has provided an extra $6.7 billion over last year for the largest single funding increase in the 77-year history of the Department of Veterans Affairs. This funding is primarily aimed at:

* X Strengthening quality health care for 5.8 million patients, including about 263,000 Iraq and Afghanistan veterans, in the 5th year of the war in Iraq;

* X Investing in much-needed maintenance for VA health care facilities and treatment for Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury for returning veterans;

* X Reducing the backlog of veterans (400,000 claims) waiting for their earned benefits by adding 1,800 claims processors.

* X Building on the first steps by this Congress at the beginning of 2007 - increasing veterans' health care and benefits by $5.2 billion for improved care and shorter waiting lines for veterans waiting 177 days to receive their earned benefits.

• Print
• Comments
• Trackbacks

In the ongoing quest to understand and treat war injuries, the NIH has shown that certain organic injury to the brain actually reduces the the occurence of non-organic injury.

NINDS is a component of the National Institutes of Health (NIH), and is the nation's primary supporter of biomedical research on the brain and nervous system.

Brain scans of combat-exposed Vietnam War veterans showed that certain serious head injuries to certain parts of the brain can prevent soldiers from developing post-traumatic stress disorder (PTSD).

The findings, from the National Institutes of Health (NIH) and the National Naval Medical Centre, suggested that drugs or pacemaker-like devices aimed at dampening activity in these brain regions might be effective treatments for PTSD.

Jordan Grafman, Ph.D., a senior investigator at the National Institute of Neurological Disorders and Stroke (NINDS), part of NIH, turned to the Vietnam Head Injury Study (VHIS) to make that distinction. The VHIS is a registry of Vietnam veterans who sustained penetrating brain injuries (which are less common in Iraq compared to concussion brain injuries). It has received support from the Department of Defense, the Department of Veterans of Affairs and NIH, and is currently supported by NINDS.

"If we could show that lesions in a specific brain region eliminated PTSD, we knew we could say that the region is critical to developing the disorder," said Dr. Grafman. The results of his study appear online today in "Nature Neuroscience".

To read the full article click here.

• Print
• Comments
• Trackbacks

Wayne State Univiersity is leading the research with a grant to study the effect of the "invisible fist" of blast injuries.  To see a short 2 minute video click here.

Dr. Pamela VandeVord, assistant professor at Wayne State University, is seen here using a blast tube to study how pressure from explosions might cause brain injuries.  The tube mimics explosions in Iraq to study what happens in the brain.

About 1.4 million people suffer a TBI every year in the United States, according to the Brain Injury Association of America.

Researcers now believe that what was once believed to by PTSD is actually TBI; organic versus non-organic injury.

• Print
• Comments
• Trackbacks

USA Today reports that blast injuries are producing more damage than previously realized.  The war in Iraq will be no different in producing a "signature wound" only this time the wound is in the brains of those affected. Medical experts are witnessing an emerging and significant increase in Traumatic Brain Injury (TBI).

The new findings are the result of blast experiments in recent years on animals, followed by microscopic examination of brain tissue. The findings could mean that the number of brain-injured soldiers and Marines — many of whom appear unhurt after exposure to a blast — may be far greater than reported, says Ibolja Cernak, a scientist with the Johns Hopkins University Applied Physics Laboratory.

Blast injuries are getting the attention of the war as a laboratory.  And now that attention is revealing what is already known from other familiar mechanisms of injury:  brain injury occurs at the cellular level.

The North American Brain Injury Society formed a committee to examine blast injuries.  Dr. Mariusz Ziejewski, biomechanical engineer, is heading that effort.  For more information go to http://www.nabis.org/public/message.shtml

• Print
• Comments
• Trackbacks

The National Guard is now being checked for signs and symptoms of brain injury with comparisons to base line data.

Beth Pearson, senior research associate at Dartmouth Medical School in New Hampshire and the principal investigator on the National Guard project, said Thursday that explosive devices used in the wars in Iraq and Afghanistan are causing traumatic brain injuries in many service members. But without a pre-deployment baseline, it's impossible to tell whether an individual's abnormal brain function predates deployment or is related to military service, she said.

"Now we'll have a baseline measure of the neurological functioning of each person, and they'll be retested on their return for any changes," she said. That will help doctors determine which areas of the brain have been injured and improve medical treatment. Veterans Affairs officials at Togus are supportive of the project, Pearson added.

Read the full article here.

• Print
• Comments
• Trackbacks

I am pleased to learn that the military has set up a process of detecting and treating soldiers with brain injury.  The Associated Press published an article today about testing military personnel before they are sent into service.  This mini-neuropsychological test is designed to measure memory and attention, among other cognitive domains, before an injury occurs. 

Before they leave for Iraq, thousands of troops with the 101st Airborne Division line up at laptop computers to take a test: basic math, matching numbers and symbols, and identifying patterns. They press a button quickly to measure response time.

It's all part of a fledgling Army program that records how soldiers' brains work when healthy, giving doctors baseline data to help diagnose and treat the soldiers if they suffer a traumatic brain injury — the signature injury of the Iraq war.

There are an extimated 30% of patients at Walter Reed Hospital receiving care for brain injury.  Of those suffering from what is misleadingly referred to as "mild traumatic brain injury," an estimated 20% go on to suffer permanent lingering problems.  According to research. Walter Reed found that irritability and memory, two classic symtoms of brain injury, are reported more on return home then in the battlefield.

Soldiers sometimes walk away from explosions with no obvious injuries. But the concussion from the blast can have a lingering effect that is not always immediately apparent.

"They look physically normal, but their neurocognitive performance is off," said Col. Mary Lopez, a physician specializing in occupational therapy.

Most brain injuries are mild, and soldiers can recover with rest and time away from the battlefield. But the military estimates that one-fifth of the troops with these mild injuries will have prolonged or lifelong symptoms requiring continuing care.

So little is known about traumatic brain injuries that these baseline readings could become an important cornerstone for future study.

To read the full article click here.

• Print
• Comments
• Trackbacks