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These are three consolidated cases of employees who were all injured while they were performing tasks directly related to their employment. The only question raised in these cases is whether or not the employees here have suffered grave injury; that is, whether they suffered a brain injurythat results in permanent total disability. The question of what can be considered a permanent total disability has to be defined.

In the first case a Bronx ironworker fell about 19 feet to the ground. He was standing on a ladder installing a steel cupola. He was an employee of an iron works company which was then rendering iron works for a night club. The ironworker hit his head and sustained a brain injury.

He filed a suit in damages under the Worker’s Compensation Law against his employer, iron works company and the night club which hired the iron works company.

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It isn’t necessary to go into the entire pathology of primary brain damage here. Suffice it to say that it is important to use primary brain damage to understand the initial level of consciousness of a patient and any neurological problems that might immediately be apparent, doctors in The Bronx and Brooklyn have determined.

Any changes that occur in the first few moments after injury should be understood whenever possible, so they can be treated as soon as possible. The damage caused directly the impact could very well be aggravated by secondary brain damage, resulting in effects ranging from concussion to coma and death, sources have learned. For example, a object that penetrates the skull will obviously cause direct damage, but it may also cause some loss of function or impairment. Any further loss of consciousness or brain function would be caused by secondary brain damage.

Experimental research has shown swelling occurs at the site of the injury within 15 minutes of traumatic brain injury. As hours pass, the injury can continue to worsen, due to misalignment of parts of the brain. Pressure inside the skull can increase, subjecting the brain to forces that will make matters even worse. Doctors have determined the first few minutes after head injury are vital. It takes trained medical professionals who know what to do with head injury to prevent what may seem like a straightforward medical problem from becoming something far worse, something that might cause lifelong impairment or even death.

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The whole method of determining consciousness is changed when it comes to infants and young children, doctors have discovered. Often, the severity of a head impact is overestimated, but it’s much more common for the reverse to be true. When an infant cries because of a head impact, it is thought to indicate full consciousness, when in fact serious brain damage may have occurred.

The Glasgow Coma Scale (GCS) uses verbal and motor responses to assess consciousness, which is not possible for preverbal infants. Even after they learn to speak, a frightened but fully conscious child might not be able to fully aid in assessing his or her own state of mind. Doctors in The Bronx are well-aware of attempts to devise a scale that operates for children who are five years of age or less, so their needs can be better served.

Pediatricians and neurological nurses have studied these preverbal responses and are of great help in devising a scale that can assist in the treatment of small children. One such scale includes social, adaptive, vocal and motor responses, and even suck/cough responses, either spontaneous or induced by stimulus. Each of these was given a score from 0 to 4. Another scale was based off the Glasgow scale for eye opening and motor responses, but it had different criteria for the verbal portion, including such things as smiling, eye orientation, consolability, and interaction.

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Traumatic brain injury, not caused by flying objects, can be divided by physicians into primary and secondary types, according to doctors in The Bronx. The force that causes the injury directly damages blood vessels, brain cells, and other parts of the brain, which in turn cause secondary damages like inflammation, and changes in neurochemistry and metabolism. The study of these secondary injuries has lead to a number of pharmacological therapies that can help limit this type of damage.

The primary damage is anything that is a direct result of the force that caused the injury, which deforms the tissue at the moment of injury, New York Brain Injury Lawyers have learned. This is blood vessel damage, damage to brain cells, and other brain injuries that have a different effect depending upon the parts of the brain that are harmed in the initial impact.

Secondary traumatic brain damage is a complication of the primary damage and often includes cerebral swelling, changes in pressure inside the skull, and infection. Secondary brain damage is sometimes reversible with treatment. Study of these injuries have enabled pharmacologists to develop therapies that can do a lot to mitigate the harm done by a head impact. These studies in Brooklyn have also shown Lawyers, among others, that brain injury is not a single type of injury, but one that has many different manifestations that can occur and combine in any number of ways.

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Deaths from ‘injury and poisoning’ are fourth in age-standardized rates for males and females in most Western countries, according to studies, coming after circulatory, neoplastic, and respiratory diseases.

For young people in many nations, traffic-related incidents are the most likely cause of death. Though the numbers have been decreasing over the decades, percentage-wise, it is still something many physicians and other health specialists have to deal with regularly. Many of the instantaneous deaths from these accidents were due to chest and multiple injuries, but those that managed to reach the hospital and died subsequently mostly died due to injuries to the head.

Head injuries are always a high proportion of fatal injuries, doctors in The Bronx have learned. These injuries are often motor-vehicle related and among these, in many places, head injuriesare the leading cause of death.

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No one is certain what really causes primary explosive blast traumatic brain injury (bTBI), according to doctors. Clearly, the “cause” is the explosion and the mechanism by which it works is the interaction of explosive force upon the human body, but this does not medically explain everything that occurs.

There are primary and secondary injury mechanisms when it comes to trauma. Primary injury mechanisms can be attributed directly to the cause of the injury, like laceration from a cut. Secondary injuries are physiological responses, like bleeding or bruising. When it comes to bTBI, doctors have learned, there is probably more than one primary injury mechanism involved. Hospitals in the Bronx and Brooklyn are studying this.

The blast produced by an explosive device travels through a medium like air or water in a wave of pressure. Basically, a great deal of energy is chemically produced. Mechanical, thermal, and electromagnetic energy is transferred into the surrounding medium, and into anyone who happens to be in the blast radius.

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The symptoms of bTBI (explosive blast traumatic brain injury) can actually be very subtle, doctors tell studies. Sometimes, there is no outward sign of injury until certain symptoms begin to arise, like headaches, vertigo, or short-term memory loss. Because of this, victims of bTBI should be evaluated by a physician or psychologist to determine how extensive their injuries might be, if any. Neurophysical evaluation should be a part of this examination. There are currently efforts to create neuropsychological tests that can be automated on laptop computer or are easy enough to be used to by first responders who may have less training.

Patient who may have PTSD (post-traumatic stress disorder) should see a combat stress team provider or a psychiatrist as soon as possible. It is very important to remember, doctors have learned, that bTBI and PTSD can have very similar symptoms and may occur alone or together in a patient. It may be difficult to tell them apart.

When TBI may be present in a patient, that person should be excused from all combat-related duties. The patient should be put on light duty until the symptoms are gone or until he or she is moved to a place where advanced neuroimaging, like MRI, may be used, and a more detailed evaluation can be used. Doctors in Bronx and Queens hospitals have determined that it is vital for a patient suffering TBI, or who may be suffering from it, to be treated with the utmost care, so the condition does not become worse.

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It is important to learn more about brain injury so they might be better treated, Lawyers have determined. There are three major means researchers have used to learn more about such things: experimental, mathematical, and observational.

Many of the things people know about brain injury comes from experimental studies. Test subjects have included human cadavers, anesthetized animals, and animal cadavers. In some cases, physical models or computer models of heads can also be used. Experiments conducted on living humans are limited to non-injurious impact, of course.

When it comes to human cadavers, doctors have learned, there is representation of what happens to the general anatomy, but not to systems like the circulatory system, because the cadaver has no working organs. And animals differ enough from humans that beneficial details may be lost in such experiments.

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The fact is that most patients who suffer head injuries are not initially managed by emergency medical services that have specialized knowledge of the pathophysiology and treatment of head injury. This is the main reason why it is helpful to divide head injuries into primary and secondary. Primary brain damage is what occurs at the time of impact and its effects occur virtually immediately. Secondary brain damage occurs at some point after the impact, not only can it be treated, but it can often be prevented with the proper care. It is vitally important that a clinician both recognizes and documents the primary damage, and then prevent or treat any secondary damage. Primary brain damage is considered to be irreversible, but even that may not be set in stone, as new medical innovations are challenging even that assumption.

Lawyers have learned that understanding the difference between primary and secondary brain damage is important for non-specialists to know. If everyone were well-informed, secondary brain damage may not even occur in such cases. Even when it doesn’t work, it adds to the knowledge of how to treat head injury so we come closer to the time when secondary brain injury can be effectively prevented in the majority of cases in The Bronx and Brooklyn.

Secondary brain damage could happen very quickly after impact, so it is important for any medical personnel who arrive on the scene to work quickly and correctly to diagnose and treat such injuries, according to New York Brain Injury Lawyers.

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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.

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