Brain Injuries: Risk Of Suicide May Increase Three Fold After A Concussion

brainI’m part of a nation-wide group of lawyers who regularly exchange articles and other information with one another about brain injury cases.

This week, we were having an online discussion about suicide, and we shared a study from earlier this year finding that persons who have suffered even a single concussion may be at a much higher risk for suicide.

What really struck me is how these risks apply to my clients.

In a Scientific American article about the study, Dr. Donald Redelmeier, one of the study’s lead authors stated:

The typical patient I see is a middle-aged adult, not elite athlete.  And the usual circumstances for acquiring a concussion are not while playing football; it is when driving in traffic and getting into a crash, when missing a step and falling down a staircase, when getting overly ambitious about home repairs — the everyday activities of life.

These are the things we routinely see in our practice. Over the last year, I’ve represented clients who have had brain injuries in car wrecks, bicycle wrecks, slip-and-fall accidents, and more.

Too often the diagnoses of these injuries is slow, and in many cases, not recognized until very late in the process.   This delays the treatment, including the psychological treatment, that clients need to help them start the road to recovery from these devastating injuries.

 

Playground Concussions Are On The Rise

brainOne of the recent headlines on Yahoo News was a story that playground concussions are on the rise.

You might be surprised to find that I think this is great news.  Why?

I don’t think the actual number of concussions are rising.  Instead, I think parents and school nurses and such are getting much better at looking for and diagnosing concussions.

This diagnoses is important.  I not only see kids affected with brain injuries in my practice, but I’ve watched my own kid struggle with a concussion.

These are serious injuries that need to be treated seriously.  But they can’t be properly treated if they’re not diagnosed.

There are also potential legal aspects in these claims.  For example, depending on the circumstances, a playground injury may give rise to a claim or lawsuit against:

  • the party that owned the playground
  • the party who designed the playground
  • the party who built the playground
  • the party who was responsible for maintaining the playground
  • the party who made modifications to the playground

If your kid is hurt on a playground, the first order of business is to make sure they get the care they need.  After that, if the problems are serious, then talk to a lawyer to discuss your options.

New Study Explains Why Rest Is Key Following A Brain Injury

brainWhen my son suffered a concussion two years ago, his doctor told him the key was rest.  For this then 11 year old, that meant laying down, with no reading, no television, and no video games.  Just rest.

Rest has long been thought to help following a brain injury, but recently, a new study came out explaining why that was the right advice.

The study, which examined trauma in the brains of mice, found that when there is single, mild incident, the mice lose 10-15 percent of their neuronal connections in the brain, but there was no accompanying cell death.  When the mice rested for three days, almost all of the connections came back, healing the brain.

However, the study found that without rest, when additional events occur, the neuronal connections don’t heal and can become permanent.  Thus, the prescribed rest is critical to offer the brain an opportunity for any mild injuries to heal.

One issue with the study is that it is only based on very mild injuries.  In more severe cases, a one-time incident can cause cell death and have long-term consequences even if the victim tries to take the rest needed or prescribed.

If you or a loved one has suffered a brain injury as a result the conduct of someone else, please call us at (512)476-4944 so we can help you.

 

 

 

Energy Drinks Linked To Brain Injuries

brainA new University of Toronto study found that teenagers who drink heavily caffeinated energy drinks are more prone to traumatic brain injuries.

In the firm, I see brain injuries in all sorts of situations — car wrecks, bicycle accidents, falls, etc.  But for teenagers, the most common cause of traumatic brain injuries is sports.  The rate of brain injuries in teens has been on a rise (in part, I think, because of better diagnoses).

The new study sheds some additional light on the problem.  The researchers interviewed 10,000 people from ages 11-20 and asked a series of questions, including questions about usage of energy drinks and their incidents of brain injuries.  The results were startling.

Those kids who had consumed one energy drink in the last year were twice as likely to have suffered a brain injury and non-drinkers, and those kids who consumed five or more energy drinks in the last week were nearly seven times more likely to have sustained a brain injury.

These results don’t necessarily show that the use of energy drinks makes a person more likely to suffer a brain injury from an event.  But it’s possible.  The high caffeine levels affect the brain in ways that we don’t know, and the caffeine levels could make the brain more susceptible to injury.  More study is needed there.

Alternatively, there is some thought that there is a correlation between the use of energy drinks and high risk behavior.  Maybe people who drink energy drinks engage in activities that are more dangerous than what a typical kid experiences.

Finally, there is the possibility that the use of energy drinks is a coping mechanism to deal with the after-effects of brain injuries.  Many kids with brain injuries describe themselves as being tired or in a fog.  Perhaps the usage of energy drinks is a way to fight off those symptoms.

There is still a lot to learn on these topics, but there is enough concern that I think we should discourage the use of these energy drinks by kids until we know that they’re safe.

New Baseball Study Shows Even When Brain Injured People Appear “Normal”, They’re Not

baseball2I recently saw a study that is near and dear to my heart on two subjects — baseball and concussions.

One of the biggest frustrations of people with head injuries is that even though they look normal to their friends and family members, something is off.  Now, a new study involving professional baseball players provides a strong example of how people are impaired even though they look (and even feel) normal.

The study, reported in the American Journal of Sports Medicine and summarized in the New York Times, followed Major League Baseball position players (non-pitchers) who returned to action following concussions.  What the researchers found was stunning.  These batters, even though they themselves felt they were no longer impaired, performed significantly worse in the weeks following their return to play.

The study looked at 66 players over several years who had concussions.  In the two weeks before their concussions, they players had an average batting average of .249, an on-base percentage of .315, and a slugging percentage of .393.  For the two weeks after their return from the injury, the batting average had dropped to .227, on-base percentage had fallen to .287, and slugging percentage had fallen to .347.

Despite these players feeling that they were fine and back to normal, their batting averages and on-base percentages had each fallen by almost 9%, and their slugging percentages had fallen by almost 12%.

In order to rule out the idea that the drop off was just from the players being away from the game, the researchers also studied players who had taken a similar amount of time off for bereavement or paternity leave.  For those players, the batting averages, on-base average, and slugging percentages all INCREASED after their breaks.

This study is strong evidence for two things:

1) even though victims of brain injuries may appear normal to the outside world, they may still be impaired; and

2) that victims of concussions and head injuries are likely impaired in all types of ways for far longer than even the injured persons suspect.

Brain Injury Symptoms: Balance, Dizziness, Smelling, Hearing & Sight

The human brainAs I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

These are the final common symptoms on my list.  They seem unrelated, but they’re all related to a change in the senses.

Balance & Dizziness Issues.  Unfortunately, many  of you may experience balance or dizziness issues following your brain injury.  These are very common symptoms of brain injuries and sometimes they can be severe.  Some with brain injuries can feel the immediate problems, but tests can help make the diagnoses.  (With my son’s concussion, he appeared healed and ready to return to baseball until his medical provider ran balance tests on him, which revealed he was still experiencing significant problems despite seeming normal.)  For persons with severe cases of balance and dizziness issues, the person can undergo vestibular therapy that can help fight these symptoms.

Smelling & Tasting.  Oddly enough, many victims of brain injuries experience problems with their sense of smell and taste.  These can run the gamut from completely losing the ability to smell or taste, to a decreased ability to do both, to always experiencing a foul or unpleasant taste or smell.  Unfortunately, there is little that can be done in many of these cases.

Hearing.  Some studies suggest that between 48 and 74% of all people who sustain head trauma will have some type of hearing loss.  These losses could be caused by actual damage to the hearing system (ear canal, etc.) to neurologic problems that are a result of damage to the brain itself.  The treatment options obviously change based on the type and severity of the injury sustained.

Vision.  Recent studies at some VA hospitals have found that more than 74% of the patients with brain injuries had vision problems.  There can be a number of different causes of vision problems.  There can also be a number of different treatment options ranging from waiting, to patching one of your eyes, to vision therapy, to surgery.

Brain Injury Symptoms: Behavioral and Emotional Symptoms

The human brain

INTRODUCTION

As I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

You may only realize that you or a family member has a brain injury because you notice changes in you or your family member’s behavior or emotional status.  Some of the common emotional or behavioral issues that we see from brain injuries are as follows:

Irritability.  Many survivors or friends of survivors find that the injured person is more irritable and much more easily angered.  The injured person may also have an angry response to a situation that is greatly out of proportion to what you would normally expect.

Impulsivity.  Many brain injury survivors have problems with impulse control.  They say things they wouldn’t normally say; they take physical actions they wouldn’t normally take; or they demonstrate poor judgment failing to fully think things out.

Affective instability.  Many persons with brain injuries show exaggerated displays of emotion that are way out of proportion to the situation or to the person’s pre-injury self.  As mentioned above, some persons become explosively angry at something that doesn’t seem justified.  Others may become extremely sad over something that doesn’t warrant such a response.

Apathy/Lack of Motivation.  Apathy is very common in persons with brain injuries.  One study has found that more than 60% of brain injury victims suffer some form of apathy.

Depression.  Some studies find that between 30 and 60 percent of brain injury victims have depression.  This doesn’t include the significant percentage of victims who experience some symptoms of depression, but not enough for a formal diagnoses.  Additionally, if victims had depression prior to their injury, a brain injury can make that depression much more severe.

Psychosis.  Psychosis is an infrequent (but high impact) occurrence with brain injuries.  Typical symptoms of psychosis might be delusions, hallucinations, or schizophrenia-like problems.  As I said, these are rare problems in brain injuries, but when they occur, they are very problematic for the affected person.

General Anxiety Disorder. Many brain injury victims describe feelings of anxiety.  If a person has experience anxiety before their injury, then they are much more likely to experience even worse anxiety after the injury.

Obsessive Compulsive Disorder.  A small percentage of brain injury victims develop OCD after their injury.

Post-Traumatic Stress Disorder.  There are a number of studies finding that victims of brain injuries are also likely to experience PTSD.  This is a problem that is being highlighted by the experiences of our soldiers in the middle east conflicts.  PTSD is also problematic because it makes recovery much more difficult.

Substance Abuse.  Several studies find that victims of brain injuries are much more likely to experience substance use disorders.

Dementia.  There are substantial studies finding that brain injuries both increase the likelihood that the victim develops dementia and also may result in earlier-onset dementia for those who are already pre-disposed to developing dementia.

 

Brain Injury News: Ohio State Football Player Found Dead After Head Injuries

The human brainThere was tragic head injury-related news out of Ohio this weekend.

Yesterday, two individuals sifting through a dumpster in Columbus, Ohio found the body of Ohio State football player Kosta Karageorge, who had apparently committed suicide.

Karageorge had been missing since Wednesday.  Earlier that day, he sent an ominous text message to his mother that his concussions have his head messed up, he left his apartment, and he had not been seen since then until his body was discovered.

I hope that Karageorge’s death is not in vain, but that he serves as a reminder of the importance of getting good mental health care following head injuries.  I often see people who have head injuries get a double dose of the mental anguish problem.

First, people with head injuries experience the confusion and mental health problems that result from the actual injury itself.  These symptoms can be severe and debilitating.

But head injuries are also an invisible problem.  With a broken arm or leg, friends and family members can see the injuries and can understand when you are hurt.  But head injuries aren’t like that.  Often, in addition to going through the stress and emotional consequences of the injury, injured persons also suffer additional emotional trauma from their friends and family members not really understanding that they’re hurt or the extent of their injuries.  This can only compound the problem.

If you or a loved one has sustained a brain injury, learn from this tragedy, and get the therapy or other assistance that you need.

 

 

Concussions — IMPACT Testing For Kids

My son sustained a concussion last spring while playing baseball.  During that process, my son took a test called an IMPACT test to help diagnose the concussion and to help figure out when he had recovered sufficiently to return to normal activities. But our problem was that we didn’t have a baseline.  The IMPACT test works best if the kids have taken a pre-injury test (required by many school athletics departments) to be compared to the post-injury tests.  Since the pre-injury test only costs around $20, I’ve become a big proponent of encouraging kids to take the tests.

Recently, local news station KXAN ran a good story about the tests.  If you have kids, especially those participating in sports, I urge you to watch the story and to have the kids take the test.  You can watch the story below.

 

What Are Symptoms Of A Concussion Or Brain Injury?

I often tell clients that they need to be on the lookout for brain injuries.   For some head injuries, the problems are obvious.  But in many cases, the problems are much more subtle.  As a result, many concussions or brain injuries go undiagnosed because a doctor doesn’t know you well and doesn’t see the symptoms.  Because of this, it’s important for you or your spouse or other family members to look for symptoms so you can convey that information to doctors.

Working on a case, I stumbled across this symptom chart from the Centers for Disease Controls that will help you identify potential brain injuries.  Hopefully, this will help you recognize problems so you can get the treatment and care you need.

Symptoms of concussion

Perlmutter & Schuelke, PLLC maintains offices in Austin, Texas. However, our attorneys and lawyers represent clients throughout the state of Texas, including Dallas, Houston, San Antonio, Forth Worth, El Paso, New Braunfels, San Marcos, Kyle, Buda, Round Rock, Georgetown, Lockhart, Bastrop, Elgin, Manor, Brenham, Cedar Park, Burnet, Marble Falls, Temple and Killeen. By Brooks Schuelke


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