Brain Injury Lawyer Blog

Sometimes the extent of moderate or severe damage caused by bTBI (explosive blast traumatic brain injury) is difficult to determine at first, doctors have told sources. Severe facial trauma can prevent reliable neurological examination, especially when it comes to examining the pupils for reaction. Specialized tools are often necessary to even make triage decisions that could save lives.

The chaos of war only compounds the difficulty in making decisions when it comes to severe injury. When a doctor or other medical professional is used to medical centers in the United States, where there are adequate resources and help in the form of other professionals near at hand, it can be very difficult to work on a battlefield where everything is in short supply, but the number of patients is much greater.

Difficult decisions have to be made in such environments. It isn’t uncommon for a great number of severely injured patients to arrive at the same time. Efficient triage is essential for the best use of limited resources. There may be few health care providers, no operating rooms or CT scanners, and not many blood products to go around. It may even be impossible to evacuate patients to a better facility. The whole idea behind triage is take resources that may not be adequate and stretch them out to their best possible use to help the largest number of patients. They must be stabilized and their lives preserved until they can be evacuated into a better circumstance. Hospitals in Long Island and Manhattan are watching this situation.

Explosive blast traumatic brain injury (bTBI) can be a complicated thing, sources have learned. The Centers for Disease Control and Prevention have determined secondary, tertiary, and even quaternary effects that may contribute to a particular patient’s condition.

The primary injury comes from the forces created by the explosion itself. Secondary injury might occur due to matter thrown by the explosion, like fragments from the weapon itself, or debris in the immediate environment. Tertiary injury occurs when the victim is thrown by the blast to strike a wall or the ground. Finally, quaternary injuries may occur from factors not included in the first three, like burns or inhalation of toxic fumes.

Doctors have seen that the injuries can cause a number of symptoms. It might be as mild as a brief period of confusion – or it may lead to a coma. Severe bTBI commonly leads to diffuse cerebral edema and hyperemia, developing rapidly, within an hour after the initial blast injury. This type of injury seems to be much more common with blasts, as opposed to other forms of traumatic brain injury, and this type of injury has lead to military neurosurgeons performing more decompressive craniectomies more often than they would for penetrative traumatic brain injury (pTBI) or closed head traumatic brain injury (cTBI).

There is a challenge for researchers in New York City and Westchester in finding a unique clinical description for bTBI. The data is still coming in when it comes to the specific details of this type of injury. Those who suffer from bTBI also have other serious injuries, such as traumatic limb amputation and hemorrhagic shock.

The ongoing Global War on Terror has resulted in an increase of traumatic brain injury, or TBI, doctors have noted. A number of them suffer from an explosive blast (bTBI). Physicians have decided this type of injury is distinct from other forms of brain trauma, such as penetrating TBI (pTBI) and closed head TBI (cTBI).

Explosive blast causes more than 60% of combat casualties in the two current major American campaigns, Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom, according to studies. The main source of danger are the much talked-about IEDs – improvised explosive devices. The head is often injured in battle, accounting for 20% of all combat-related injuries in modern wars. When it comes to the wars in Iraq and Afghanistan, the data is still coming in. So far, the data seems to closely match that of previous wars.

Operation Iraqi Freedom and Operation Enduring Freedom are distinct from 20th century wars in the higher survival rate of those who are injured in combat, even those who suffer from TBI, according to studies. An important factor to be considered is the use of body armor. Doctors in Nassau and Suffolk used to believe that the severity of bTBI was due to pTBI from fragments of the explosive device or cTBI from the head striking an object after the victim was thrown.

The modern combat helmet has prevented many instances of pTBI, but it might have limitations when it comes to injury from impact. bTBI can be as severe as any other injury, without a penetrating injury and without the victim being thrown, which means even the excellent armor of the modern soldier can fully protect from bTBI.

The current conflicts in Iraq and Afghanistan have led to a great many more serious injuries to United States service members. One of the most prevalent and dangerous is explosive blast traumatic brain injury (TBI). Doctors have been studying the rising trend.

There have been a number of military medical treatments for blast TBI which have been a success in the war theater, such as decompressive craniectomy, cerebral angiography, transcranial Doppler, hypertonic resuscitation fluids, and others. There has been similar progress stateside in neurosurgery, neuro-critical care, and rehabilitation for patients suffering injuries caused by blast TBI.

As they continue to treat these injuries, military physicians have been able to clinically categorize many types of blast TBI. One of these important discoveries is the development of psuedoaneurysms and vasospasm in severe blast TBI victims, which can cause delayed decompensation. Another is that mild blast TBI often has very similar clinical features to post-traumatic stress disorder (PTSD). Some physicians have conclude that the injuries explosive trauma causes to the nervous system might be more complex than might appear at first examination.

Scientists in The Bronx and Brooklyn concur with physicians who say more study is needed at both the basic scientific and clinical levels, including detailed biomechanical analysis, so more might be known about the effects of blast TBI. A comprehensive epidemiological study may also be needed to see just how widespread the disease is, and what factors can contribute to explosive blast neurotrauma. It was once considered to be strictly a military concern, but there are signs it is becoming a civilian problem as well.

Blast TBI (traumatic brain injury) happens to many combatants, according to a study. It can rightfully be considered a new class of TBI. While it might share a lot of features with standard TBI, it has some unique aspects that are all its own.

The milder forms of TBI can be very similar to PTSD (post-traumatic stress disorder), but it also has distinct aspects of its own. The military currently uses civilian standards of care for TBI when it comes to bTBI (explosive blast TBI), but they are constantly revising their standards to better provide for those injured on the field, according to sources. The theater of war requires different standards of medical practice.

It is apparent that there need to be more studies done on the precise effects of bTBI, both scientifically and clinically. The research will have to be focused upon how explosive blasts can lead to TBI. It is also important to learn how prevalent this disease is, and the exact causes. Once the research reaches a certain level, it will become much easier to diagnose and treat bTBI. A clinical definition of bTBI should quickly create the means to treat bTBI.

bTBI is currently a disease that is most likely to occur in soldiers, but there is a high chance that it may become more common among civilians in Manhattan and Long Island as well. It should be watched very closely so cases of bTBI can be quickly and effectively treated, as it should be.

The treatment and prevention of head injury has advanced a great deal over the past twenty years, doctors have discovered. Many lives have been saved by these medical advances. That does not mean, however, that head injury is still not a concern all over the world. There are still many head injuries, and they can cause a large number of differing problems. Head injury patients have specific difficulties when it comes to rehabilitation and reintegration into society.

It is important, according to studies, that information regarding the frequency, causes, and outcomes of head injury be collected, so these challenges can be better met. The data can be used to find ways to prevent head injuries before they even occur, or to minimize brain injury when they do occur. Such studies focus on entire populations, rather than individuals, allowing one to see trends that might otherwise be missed.

The problem with head injury is that it is not so easy to obtain, according to Lawyers. Such injuries can occur anywhere at any time. Depending upon the location, care might be difficult to come by, which means information on the injury is difficult to collect. Most countries as well as places like New York City and Queens make it mandatory to report both deaths and the causes of death, but some places do not standardize such information. Often, the information is incomplete, resulting in a bias in the information recorded, which makes it largely useless for a wide-ranging study of the causes and effects of head injury.

Another factor that doctors need to consider when it comes to head injury is the location of the impact on the head. Where an impact deforms the skull, or the level of the acceleration of the head, can be very important in determining the nature of a head injury.

When the skull is deformed by an impact, it generally causes injury to the brain through direct contact. This is a common occurrence when it comes to an object displacing part of the skull so it hits the brain tissue. Studies, however, have discovered there are some impacts that can indent the skull for just a few milliseconds, but the skull will return to its original shape, without any evidence in the bone.

Experiments using anesthetized monkeys showed doctors that occipital impacts did not deform the skull, nor did it create any lesions on the brain. Impacts in the temporoparietal region of the brain did show evidence of skull deformation, however, along with the accompanying lesions on the brain. This is further proof that the location of impact is very important, and can mean the difference between a major and a minor injury. Studies in New York City and Westchester have shown that impacts that produce a skull fracture in one region of the skull may have to be at least twice as forceful to cause a fracture in another part of the skull.

All evidence such as this is important not only to doctors, but to Lawyers, in order to determine what course of action is best for any given patient.

Information collection is an important component of dealing with head injuries. The use of registry systems for head injuries will allow medical professionals to track patterns of injury and learn better methods of preventing them. The lack of proper pre-hospital care can mean the difference between life and death. Most developed countries today, however, are adequately prepared to care for and transport patients when a head injury has occurred.

Pre-hospital care is another thing to consider when it comes to head injuries, according to doctors. Modern trauma care systems have refined resuscitation, triage, evacuation and primary and secondary care for the patient with severe or multiple injuries so that more lives are being saved than ever before. The system is regionalized in order to provide the best possible care, depending upon the specific circumstance. Regional Resource Trauma Centers provide education and research programs, as well as all levels of care. Community Trauma Centers provide care, but not education or research. Rural Trauma Hospitals in Nassau, Long Island may have limited resources, but they are able to stabilize then transfer patients to another facility.

Head injuries are a component in the vast majority of fatalities due to trauma. The involvement of neurosurgeons and systems of care reduce these fatalities dramatically, according to doctors. Minimal standards for the treatment of severe neurological injury have been suggested and even implemented in many places. Underfunding and difficulty in recruiting medical professionals to trauma care remains a problem, however.

When it comes to injury of any kind, including head injury, classification of severity is important. The first AIS (Abbreviated Injury Scale) was published in 1971, propelled by the American Medical Association, the Association for the Advancement of Automotive Medicine, and the Society of Automotive Engineers. It was originally created to assess impact injuries, but it has been revised a number of times since then.

The scale uses numbers to rank injuries by severity, based upon the anatomical injury. This means that any lingering consequences of the injury, like disabilities, are not noted. Each injury only receives one AIS score, and there is no single assessment for multiple injuries.
The system has a 6-point scale, with 1 meaning a minor injury and 6 being the worst possible injury. Later revisions included a six-digit code for each injury. The first number signified body region, the second anatomic structure, the third and fourth the specific nature of an injury if external, and the fifth and sixth related to the level of injury in an anatomic region. Later revisions included further categorization for brain injuries.

The AIS also provides a way to classify head injury based on the level of consciousness according to the Glasgow Coma Scale and studies done in Nassau and Suffolk. These are only used when there seems to be a more serious injury than the actual trauma suggests or when there is no visible sign using imaging or autopsy.

Head injury data can come from a number of sources, according to Lawyers, allowing for a comprehensive study of the causes and effects, so treatment might be more efficient and effective – or even so such injuries can be prevented entirely, in some cases.

National public health records in New York City and Westchester are largely mortality studies from death certificates. There may be some information available from hospital admissions, depending upon the country, doctors have found. In fact, in some locations, the authorities keep records of cause-related injuries, like industrial injuries.

Studies specifically related to head injury can also be a good source of data. These can be used to study such things as incidence and mortality rates across an entire nation. This can be difficult, however, when it comes to a large population. Whatever findings the studies reveal might underestimate the real rates.

A study can also be based upon population, taking a single group in a state or even a county, or an urban or rural area to take a sample of head injury incidences. Simply put, the smaller the size of the sample, the greater the chance of gaining an accurate measure of the true incidence of head injuries.

Another source of information is clinical topic reports. When it comes to head injuries, a clinical study can further categorize the injuries as mild, moderate, or severe and give more detailed information in general about the injury itself, such as how it occurred, and the conditions associated with it, such as vehicular accidents, or sporting accidents, or falls.

The current conflicts in Iraq and Afghanistan have led to a great many more serious injuries to United States service members. One of the most prevalent and dangerous is explosive blast traumatic brain injury (TBI). Lawyers have been studying the rising trend.

There have been a number of military medical treatments for blast TBI which have been a success in the war theater, such as decompressive craniectomy, cerebral angiography, transcranial Doppler, hypertonic resuscitation fluids, and others. There has been similar progress stateside in neurosurgery, neuro-critical care, and rehabilitation for patients suffering injuries caused by blast TBI.

As they continue to treat these injuries, military physicians in The Bronx and Brooklyn have been able to clinically categorize many types of blast TBI, according to studies. One of these important discoveries is the development of psuedoaneurysms and vasospasm in severe blast TBI victims, which can cause delayed decompensation. Another is that mild blast TBI often has very similar clinical features to post-traumatic stress disorder (PTSD). Some physicians have conclude that the injuries explosive trauma causes to the nervous system might be more complex than might appear at first examination.

Sources concur with physicians who say more study is needed at both the basic scientific and clinical levels, including detailed biomechanical analysis, so more might be known about the effects of blast TBI. A comprehensive epidemiological study may also be needed to see just how widespread the disease is, and what factors can contribute to explosive blast neurotrauma. It was once considered to be strictly a military concern, but there are signs it is becoming a civilian problem as well.

Lawyers have learned of a new classification for traumatic brain injury (TBI), known as explosive blast traumatic brain injury (bTBI). Previously, physicians divided TBI into two categories, penetrating traumatic brain injury (pTBI) and closed head traumatic brain injury (cTBI). Blast TBI is similar, but has some aspects that are all its own.

Penetrative TBI involves the penetration of a foreign object through the bones of the skull and into the brain parenchyma. This physically disrupts neurons, glia, and fiber tracts, which is made worse by ischemia and hemorrhage. Victims of this type of injury show signs of impaired consciousness and neurological difficulties associated with the parenchyma injured by the intrusion of the foreign object. An object penetrating at high velocity, like a bullet, will cause a great deal more damage, due to cavitation of brain tissue. There will be a breach in the skull where the object entered, and possibly another at the point of exit. pTBI is often easy to spot.
Closed head traumatic brain injury, is sometimes more difficult to spot. The brain moving inside the skull and deformation of the brain can cause injury to the brain parenchyma, blood vessels, and fiber tracts.

In cases involving bTBI, outside physical forces from detonation cause injury to the head and brain. The forces that cause such injuries are not fully understood. The skull may or may not be breached, which is why patients can have symptoms that look more like cTBI, pTBI, or both, when it is, in fact, neither. Hospitals and doctors who practice in The Bronx and Brooklyn are aware of circumstances like this and looking all the time for answers to the questions presented.